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M e t i c i l i n - r e z i s t e n t n i S t a p h y l o c o c c u s a u r e u s ( M R S A ) p r e d s t a v l j a z n a
a j a n m e d i c i n s k i p r o b l e m s k o j i m s e b o l n i c e s u o
a v a j u v e d e s e t l j e i m a ; n j e g o v a p o j a v a u i z v a n b o l n i
k o j s r e d i n i 9 0 - t i h g o d i n a p r o al o g s t o l j e a o t v a r a m e u t i m n o v o p o g l a v l j e i u i z v a n b o l n i
k i m i n f e k c i j a m a . I z v a n b o l n i
k i M R S A r a z l i k u j e s e o d b o l n i
k o g a p o g e n o t i p s k i m i f e n o t i p s k i m s v o j s t v i m a . T i p i
n o z a i z v a n b o l n i
k e M R S A j e d a s u o s j e t l j i v i n a v e i n u n e - b e t a - l a k t a m s k i h a n t i b i o t i k a . U z r o k u j u i n f e k c i j e u m l a i h , p r e t h o d n o z d r a v i h l j u d i a n a j
e ae s u u z r o
n i k o m t e ak i h i n f e k c i j a k o ~e i m e k i h t k i v a k a o i t e ak i h , n e k r o t i z i r a j u i h p n e u m o n i j a .
K r o m o s o m a l n a k a s e t a k o j a s a d r ~i m e c A g e n o d g o v o r a n z a r e z i s t e n c i j u n a b e t a - l a k t a m s k e a n t i b i o t i k e ( S C C m e c ) u i z v a n b o l n i
k h i z o l a t a j e t i p a I V i l i V , m a n j a j e o d S C C m e c t i p i
n i h z a b o l n i
k e i z o l a t e ( S C C m e c I , I I , i I I I ) . T i p i
n o j e z a v e l i k i d i o i z v a n b o l n i
k i h M R S A p o s j e d o v a n j e g e n a z a P a n t o n e - V a l e n t i n e l e u k o c i d i n ( P V L ) .
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k i h M R S A k o r i s t e s e s t a n d a r d n e l a b o r a t o r i j s k e m e t o d e a u u g r o ~e n o j p o p u l a c i j i m o g u e j e p r i m i j e n i t i b r z e m o l e k u l a r n e m e t o d e z a c i l j a n o l i j e
e n j e i s p r e
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k i h M R S A i z o l a t a .
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S t a p h y l o c o c c u s a u r e u s ( S . a u r e u s ) p r e d s t a v l j a j e d n o g o d n a j z n a
a j n i j i h i n a j a d a p t a b i l n i j i h l j u d s k i h p a t o g e n a . K o l o n i z i r a n o s n i v e s t i b u l u m u o k o 3 0 % z d r a v i h l j u d i , i d o 5 0 % n e k i h s k u p i n a b o l e s n i k a ( n p r . b o l e s n i c i n a k r o n i
n o j h e m o d i j a l i z i ) a n a j
e ae i z a z i v a i n f e k c i j e k o ~e , p o t k o ~n o g t k i v a a l i i b a k t e r i j e m i j u , p e n u m o n i j u , e n d o k a r d i t i s , i n f e k c i j e k o s t i i z g l o b o v a , i n f e k c i j e s r e d i an j e g ~i v
a n o g s u s t a v a , i d r u g e i n f e k c i j e . S . a u r e u s r a z v i o j e d o s a d a r e z i s t e n c i j u n a s v e a n t i b i o t i k e k o j i s u k o r i at e n i u l i j e
e n j u s t a f i l o k o k n i h i n f e k c i j a . S r e d i n o m p e d e s e t i h g o d i n a p r o al o g s t o l j e a u b r z a n o s e p o v e a o u d i o i z o l a t a r e z i s t e n t n i h n a p e n i c i l i n A D D I N E N . C I T E < EndNote>Jessen196927927917Jessen, O.Rosendal, K.Bulow, P.Faber, V.Eriksen, K. R.Changing staphylococci and staphylococcal infections. A ten-year study of bacteria and cases of bacteremiaN Engl J MedN Engl J Med627-3528112AdolescentAdultAge FactorsAgedBacitracin/pharmacologyBacteriophage TypingChildChild, PreschoolChloramphenicol/pharmacologyCross Infection/epidemiologyDenmarkErythromycin/pharmacologyGenetics, MicrobialHospitalsHumansInfantLysogenyMethicillin/pharmacologyMiddle AgedNeomycin/pharmacology*Penicillin ResistancePenicillins/pharmacologySepticemia/epidemiology/etiology/*microbiology/mortalitySex Factors*Staphylococcal Infections/epidemiology/mortalityStaphylococcus/*drug effects/isolation & purificationStreptomycin/pharmacologyTetracycline/pharmacology1969Sep 185194719http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=5194719 < / E n d N o t e > ( 1 ) m e h a n i z m o m i z l u
i v a n j a b e t a - l a k t a m a z e , k o j i s e t e r a p i j s k i p r i m j e n j u j e o d 4 0 - t i h g o d i n a , d a b i d a n a s b i o p r a k t i
k i n a p u at e n k a o l i j e k i z b o r a .
R e z i s t e n c i j a n a m a k r o l i d e , l i n k o z a m i d e i s t r e p t o g r a m i n B r a z v i l a s e p u t e m k l a s i
n i h m e h a n i z a m a : r i b o s o m s k o m m o d i f i k a c i j o m , p o s r e d o v a n o m e r m g e n o m , i a k t i v n i m e f l u k s o m m a k r o l i d a , p o s r e d o v a n o m g e n i m a m s r A A D D I N E N . C I T E < E n d N o t e > < C i t e > < A u t h o r > L e c l e r c q < / A u t h o r > < Y e a r > 1 9 9 1 < / Y e a r > < R e c N u m > 4 1 < / R e c N u m > < r e c o r d > < r e c - n u m b e r > 4 1 < / r e c - n u m b e r > < r e f - t y p e n a m e = " J o u r nal Article">17Leclercq, R.Courvalin, P.Service de Bacteriologie-Virologie-Hygiene, Hopital Henri Mondor, Universite Paris XII, Creteil, France.Bacterial resistance to macrolide, lincosamide, and streptogramin antibiotics by target modificationAntimicrob Agents ChemotherAntimicrob Agents Chemother1267-72357Anti-Bacterial Agents/*pharmacologyBacteria/*drug effects/geneticsDrug Resistance, Microbial*MacrolidesVirginiamycin/*pharmacology1991Jul1929280http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=1929280 (2).
Rezistencija na kinolone temelji se na postojanju efluks pumpe NorA i strukturnim mutacijama na ciljnom mjestu djelovanja kinolona, topoizomerazi IV i DNA girazi ADDIN EN.CITE Fournier199833033017<style face="normal" font="default" charset="238" size="100%">Mutation in topoisomerase IV and DNA gyrase of </style><style face="italic" font="default" charset="238" size="100%">Staphylococcus aureus</style><style face="normal" font="default" charset="238" size="100%">: Novel pleiotropic effects on quinolone and coumarin activity.</style>Antimicrob Agents Chemother(3).
Godine 1997. opisani su i izolati koji pokazuju smanjenu osjetljivost ADDIN EN.CITE Hiramatsu199728028017Hiramatsu, K.Hanaki, H.Ino, T.Yabuta, K.Oguri, T.Tenover, F. C.Methicillin-resistant Staphylococcus aureus clinical strain with reduced vancomycin susceptibilityJ Antimicrob ChemotherJ Antimicrob Chemother135-6401*AminoglycosidesAmpicillin/therapeutic useAnti-Bacterial Agents/therapeutic useDibekacin/analogs & derivatives/therapeutic useDrug Therapy, Combination/therapeutic useHumansInfantMaleMethicillin ResistanceMicrobial Sensitivity TestsPulmonary Atresia/complications/surgeryStaphylococcal Infections/*drug therapyStaphylococcus aureus/*drug effectsSulbactam/therapeutic useVancomycin/*pharmacology/*therapeutic useWounds and Injuries/microbiology1997Jul9249217http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=9249217 (4) a 2002. godine i rezistenciju na vankomicin, posredovanu vanA genom ADDIN EN.CITE 200228128117From the Centers for Disease Control and Prevention. Vancomycin resistant Staphylococcus aureus--Pennsylvania, 2002JamaJama211628817Bacterial Proteins/geneticsCarbon-Oxygen Ligases/geneticsCarrier Proteins/genetics*HexosyltransferasesHumansMuramoylpentapeptide Carboxypeptidase/geneticsPenicillin-Binding ProteinsPennsylvania/epidemiology*Peptidyl TransferasesStaphylococcal Infections/drug therapy/epidemiology/*microbiologyStaphylococcus aureus/*drug effects/genetics*Vancomycin Resistance/genetics2002Nov 612425311http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=12425311 (5). O d t a d a n i j e b i l o i z v i j e aa o p u n o j r e z i s t e n c i j i n a v a n k o m i c i n .
B u d u i d a s u i z o k s a z o l i l p e n i c i l i n i ( p e n i c i l i n i o t p o r n i n a d j e l o v a n j e s t a f i l o k o k n e b e t a - l a k t a m a z e ) n a j d j e l o t v o r n i j i a n t i s t a f i l o k o k n i l i j e k o v i n a j v i ae p r o b l e m a u l i j e
e n j u s t a f i l o k o k n i h i n f e k c i j a i m a o j e r a z v o j m e t i c i l i n s k e r e z i s t e n c i j e i t i m e p o j a v a i z o l a t a S . a u r e u s r e z i s t e n t n i h n a s v e b e t a - l a k t a m s k e a n t i b i o t i k e A D D I N E N . C I T E < E n d N o t e > < C i t e > < A u t h o r > L o w y < / A u t h o r > < Y e a r > 2 0 0 3 < / Y e a r > < R e c N u m > 2 < / R e c N u m > < r e c o r d > < r e c - n u m b e r > 2 < / r e c - n u m b e r > < r e f - t y p e n a m e="Journal Article">17Lowy, F. D.Departments of Medicine and Pathology, Columbia University, College of Physicians and Surgeons, New York, New York 10032, USA. fl189@columbia.eduAntimicrobial resistance: the example of Staphylococcus aureusJ Clin InvestJ Clin Invest1265-731119Anti-Bacterial Agents/metabolism/pharmacology/therapeutic useCross Infection*Drug Resistance, BacterialHumansPenicillins/metabolism/pharmacology/therapeutic useQuinolones/metabolism/pharmacology/therapeutic useResearch Support, Non-U.S. Gov'tStaphylococcal Infections/drug therapy/*microbiologyStaphylococcus aureus/*drug effects/genetics/*physiologyVancomycin/metabolism/pharmacology/therapeutic use2003May12727914http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=12727914 (6).
Meticilin rezistentni S.aureus (MRSA)
Stafilokokna kromosomal n a m e c r e g i j a ( S C C m e c )
G e n e t s k u p o d l o g u m e t i c i l i n s k e r e z i s t e n c i j e
i n i p r i s u t n o s t m e c A g e n a A D D I N E N . C I T E < E n d N o t e > < C i t e > < A u t h o r > C h a m b e r s < / A u t h o r > < Y e a r > 1 9 9 7 < / Y e a r > < R e c N u m > 2 8 4 < / R e c N u m > < r e c o r d > < r e c - n u m b e r > 2 8 4 < / r e c - n u m b e r > < r e f - t y p e n a m e = " J o u r n a l A r t i c l e " > 1 7Chambers, H. F.Medical Service, San Francisco General Hospital 94143, USA. chipc@itsa.ucsf.eduMethicillin resistance in staphylococci: molecular and biochemical basis and clinical implicationsClin Microbiol RevClin Microbiol Rev781-91104Anti-Bacterial Agents/pharmacology*Bacterial ProteinsCarrier Proteins/geneticsDNA Transposable ElementsGenome, Bacterial*HexosyltransferasesHumansMethicillin Resistance/*geneticsMicrobial Sensitivity TestsMuramoylpentapeptide Carboxypeptidase/geneticsPenicillin-Binding Proteins*Peptidyl TransferasesResearch Support, U.S. Gov't, P.H.S.Staphylococcal Infections/*drug therapyStaphylococcus aureus/*drug effects/genetics1997Oct9336672http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=9336672 ( 7 ) k o j i s e n a l a z i n a m o b i l n o m g e n e t i
k o m e l e m e n t u n a k r o m o s o m u ( S C C - s t a p h y l o c o c c a l c h r o m o s o m a l c a s s e t t e m e c ) A D D I N E N . C I T E < E n d N o t e > < C i t e > < A u t h o r > C h a m b e r s < / A u t h o r > < Y e a r > 1 9 9 7 < / Y e a r > < R e c N u m > 2 8 4 < / R e c N u m > < r e c o r d > < r e c - n u m b e r > 2 8 4 < / r e c - n u m b e r > < r e f - t y p e n ame="Journal Article">17Chambers, H. F.Medical Service, San Francisco General Hospital 94143, USA. chipc@itsa.ucsf.eduMethicillin resistance in staphylococci: molecular and biochemical basis and clinical implicationsClin Microbiol RevClin Microbiol Rev781-91104Anti-Bacterial Agents/pharmacology*Bacterial ProteinsCarrier Proteins/geneticsDNA Transposable ElementsGenome, Bacterial*HexosyltransferasesHumansMethicillin Resistance/*geneticsMicrobial Sensitivity TestsMuramoylpentapeptide Carboxypeptidase/geneticsPenicillin-Binding Proteins*Peptidyl TransferasesResearch Support, U.S. Gov't, P.H.S.Staphylococcal Infections/*drug therapyStaphylococcus aureus/*drug effects/genetics1997Oct9336672http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=9336672 < / r e c o r d > < / C i t e > < / E n d N o t e > ( 7 ) .
m e c A g e n k o d i r a p r o t e i n k o j i v e ~e p e n i c i l i n ( P B P ) 2 a , v e l i
i n e 7 8 k D a , k o j i j e s t r u k t u r n o p r o m i j e n j e n u o d n o s u n a P B P 2 u m e t i c i l i n - o s j e t l j i v i h s o j e v a , z b o g
e g a s e n a n j e g a n e v e ~u b e t a - l a k t a m s k i a n t i b i o t i c i , a p o s l j e d i c a t o g a j e n e p r e k i n u t a s i n t e z a b a k t e r i j s k e s t i j e n k e i r e z i s t e n c i j a n a b e t a - l a k t a m s k e a n t i b i o t i k e . P o s t o j a n j e m e c A g e n a n a k r o m o s o m u S . a u r e u s p o z n a t o j e v e o d 1 9 7 5 . g o d i n e A D D I N E N . C I T E < E n d N o t e > < C i t e > < A u t h o r > S j o s t r o m < / A u t h o r > < Y e a r > 1 9 7 5 < / Y e a r > < R e c N u m > 3 3 4 < / R ecNum>33417<style face="normal" font="default" charset="238" size="100%">Transformation reveals a chromosomal locus of the gene(s) for methicillin-resistance in </style><style face="italic" font="default" charset="238" size="100%">Staphylococcus aureus</style>J BacteriolSjostrom197533433417<style face="normal" font="default" charset="238" size="100%">Transformation reveals a chromosomal locus of the gene(s) for methicillin-resistance in </style><style face="italic" font="default" charset="238" size="100%">Staphylococcus aureus</style>J Bacteriol(8), a k a s n i j e s u o d r e e n e i s e k v e n c i j e r e g u l a t o r n i h g e n a m e c I i m e c R 1 , k a o i o s t a t k a S C C m e c e l e m e n t a . S C C m e c s e n a l a z i n a f i k s n o m m j e s t u n a k r o m o s o m u u n u t a r o r f X , n e p o z n a t e f u n k c i j e a l i u n e p o s r e d n o j b l i z i n i p o d r u
j a n a k o j e m p r e p i s i v a n j e p o
i n j e , at o o b j a njava njegovu brzu ekspresiju, vrlo kratko nakon prepisivanja ADDIN EN.CITE Ito2003171717Ito, T.Okuma, K.Ma, X. X.Yuzawa, H.Hiramatsu, K.Department of Bacteriology, Juntendo University, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan. teruybac@med.juntendo.ac.jpInsights on antibiotic resistance of Staphylococcus aureus from its whole genome: genomic island SCCDrug Resist UpdatDrug Resist Updat41-5261Community-Acquired Infections/drug therapy/microbiologyCross Infection/drug therapy/microbiologyDNA Transposable ElementsDrug Resistance, Bacterial/*geneticsDrug Resistance, Multiple, Bacterial/genetics*Genome, BacterialMethicillin Resistance/geneticsMutationStaphylococcal Infections/drug therapy/microbiologyStaphylococcus aureus/drug effects/*genetics2003Feb12654286http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=12654286 (9).
Prepisivanje mecA gena regulirano je djelovanjem represora, MecI i transmembranske signalne molekule, MecRI. ADDIN EN.CITE Berger-Bachi20023317Berger-Bachi, B.Rohrer, S.Institute of Medical Microbiology, University of Zurich, Gloriastrasse 32, PO Box, 8028 Zurich, Switzerland. bberger@immv.unizh.chFactors influencing methicillin resistance in staphylococciArch MicrobiolArch Microbiol165-711783Bacterial Proteins/genetics/metabolismCarrier Proteins/genetics/metabolismGene Expression Regulation, Bacterial*HexosyltransferasesHumans*Methicillin Resistance/geneticsMuramoylpentapeptide Carboxypeptidase/genetics/metabolismPenicillin-Binding Proteins*Peptidyl TransferasesRepressor Proteins/genetics/metabolismResearch Support, Non-U.S. Gov't*Staphylococcus aureus/*drug effects2002Sep12189417http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=12189417 (10).
Gen mecA, kao i regulatorni geni mecI i mecRI nalaze se na mobilnom genet i
k o m e l e m e n t u k o j e g n a z i v a m o s t a f i l o k o k n a k r o m o s o m a l n a k a s e t a m e c ( S C C m e c ) v e l i
i n e 2 , 1 k b .
S C C m e c u s e b i n o s i g e n e z a a n t i b i o t s k u r e z i s t e n c i j u i n e m a , k o l i k o j e p o z n a t o , g e n a z a
i m b e n i k e v i r u l e n c i j e A D D I N E N . C I T E < E n d N o t e > < C i t e > < A u t h o r > I t o < / A u t h o r > < Y e ar>2001282817Ito, T.Katayama, Y.Asada, K.Mori, N.Tsutsumimoto, K.Tiensasitorn, C.Hiramatsu, K.Department of Bacteriology, Juntendo University, Tokyo 113-8421, Japan.Structural comparison of three types of staphylococcal cassette chromosome mec integrated in the chromosome in methicillin-resistant Staphylococcus aureusAntimicrob Agents ChemotherAntimicrob Agents Chemother1323-36455Amino Acid Sequence*Bacterial ProteinsBase SequenceCarrier Proteins/*genetics*Chromosomes, BacterialEvolution, Molecular*HexosyltransferasesHumansMethicillin Resistance/*geneticsMolecular Sequence DataMuramoylpentapeptide Carboxypeptidase/*geneticsMutagenesis, InsertionalPenicillin-Binding Proteins*Peptidyl TransferasesPhylogenyPlant Proteins/classification/geneticsResearch Support, Non-U.S. Gov'tRestriction MappingSequence Homology, Amino AcidSequence Homology, Nucleic AcidStaphylococcus aureus/*genetics2001May11302791http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=11302791 < / u r l s > < / r e c o r d > < / C i t e > < / E n d N o t e > ( 1 1 ) .
D o s a d a j e p o z n a t o p e t S C C m e c t i p o v a v e l i
i n e o d 2 0 . 9 d o 6 6 , 9 k b i n e k o l i k o p o d t i p o v a A D D I N E N . C I T E < E n d N o t e > < C i t e > < A u t h o r > I t o < / A u t h o r > < Y e a r > 2 0 0 1 < / Y e a r > < R e c N u m > 2 8 < / R e c N u m > < r e c o r d > < r e c - n u m b e r > 2 8 < / r e c - n u m b e r > < r e f -type name="Journal Article">17Ito, T.Katayama, Y.Asada, K.Mori, N.Tsutsumimoto, K.Tiensasitorn, C.Hiramatsu, K.Department of Bacteriology, Juntendo University, Tokyo 113-8421, Japan.Structural comparison of three types of staphylococcal cassette chromosome mec integrated in the chromosome in methicillin-resistant Staphylococcus aureusAntimicrob Agents ChemotherAntimicrob Agents Chemother1323-36455Amino Acid Sequence*Bacterial ProteinsBase SequenceCarrier Proteins/*genetics*Chromosomes, BacterialEvolution, Molecular*HexosyltransferasesHumansMethicillin Resistance/*geneticsMolecular Sequence DataMuramoylpentapeptide Carboxypeptidase/*geneticsMutagenesis, InsertionalPenicillin-Binding Proteins*Peptidyl TransferasesPhylogenyPlant Proteins/classification/geneticsResearch Support, Non-U.S. Gov'tRestriction MappingSequence Homology, Amino AcidSequence Homology, Nucleic AcidStaphylococcus aureus/*genetics2001May11302791http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=11302791 Ito2004141417Ito, T.Ma, X. X.Takeuchi, F.Okuma, K.Yuzawa, H.Hiramatsu, K.Department of Bacteriology, Faculty of Medicine, Juntendo University, 2-1-1 Hongo, Bunkyo-ku, Tokyo, Japan. teruybac@med.juntendo.ac.jpNovel type V staphylococcal cassette chromosome mec driven by a novel cassette chromosome recombinase, ccrCAntimicrob Agents ChemotherAntimicrob Agents Chemother2637-51487Amino Acid Sequence*Bacterial ProteinsBase SequenceChromosomes, Bacterial/*geneticsDNA PrimersDNA Transposable Elements/geneticsDNA, Bacterial/geneticsMethicillin ResistanceMolecular Sequence DataOpen Reading Frames/geneticsPhylogenyPlasmids/geneticsRecombinases/*genetics/*metabolismRecombination, GeneticReverse Transcriptase Polymerase Chain ReactionStaphylococcus aureus/*genetics2004Jul15215121http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=15215121 (11, 12). SCCmec t i p d e f i n i r a j u r a z l i
i t e k o m b i n a c i j e m e c A k o m p l e k s a i g e n a c c r ( C a s s e t t e C h r o m o s o m e R e c o m b i n a s e ) .
S C C m e c t i p I , ( 3 4 , 3 k b ) , I V ( 2 0 , 9 d o 2 4 , 3 k b ) i V ( 2 8 k b ) i s k l j u
i v o u s e b i n o s e g e n e z a k o d i r a n j e r e z i s t e n c i j e n a b e t a - l a k t a m s k e a n t i b i o t i k e , i a k o s u M R S A izolati SCCmec tipa I gotovo uvijek multirezistentni. Pretpostavlja se da su geni rezistencije na druge antibiotike smjeteni drugdje na kromosomu. SCCmec tipovi II i III ( 53,0 kb i 66,9 kb) kodiraju i gene rezistencije na druge antibiotike, koji se nalaze na integriranim plazmidima, (pUB110, pl258 i pT181) i transpozonu (Tn554).
Plazmid pUB110 ima gen ant(4`) koji kodira rezistenciju na kanamicin, tobramicin i bleomicin, na pl258 se nalaze geni koji kodiraju beta-laktamaze i rezistenciju na teke metale. P l a z m i d p T 1 8 1 k o d i r a t e t r a c i k l i n s k u r e z i s t e n c i j u , d o k t r a n s p o z o n T n 5 5 4 s a d r ~i e r m A g e n z b o g k o j e g n a s t a j e i n d u c i b i l n a r e z i s t e n c i j a n a m a k r o l i d e , l i n k o z a m i d e i s t r e p t o g r a m i n ( M L S ) A D D I N E N . C I T E < E n d N o t e > < C i t e > < A u t h o r > I t o < / A u t h o r > < Y e a r > 2 0 0 3 < / Y e a r > < R e c N u m >171717Ito, T.Okuma, K.Ma, X. X.Yuzawa, H.Hiramatsu, K.Department of Bacteriology, Juntendo University, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan. teruybac@med.juntendo.ac.jpInsights on antibiotic resistance of Staphylococcus aureus from its whole genome: genomic island SCCDrug Resist UpdatDrug Resist Updat41-5261Community-Acquired Infections/drug therapy/microbiologyCross Infection/drug therapy/microbiologyDNA Transposable ElementsDrug Resistance, Bacterial/*geneticsDrug Resistance, Multiple, Bacterial/genetics*Genome, BacterialMethicillin Resistance/geneticsMutationStaphylococcal Infections/drug therapy/microbiologyStaphylococcus aureus/drug effects/*genetics2003Feb12654286http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=12654286 Ito2001282817Ito, T.Katayama, Y.Asada, K.Mori, N.Tsutsumimoto, K.Tiensasitorn, C.Hiramatsu, K.Department of Bacteriology, Juntendo University, Tokyo 113-8421, Japan.Structural comparison of three types of staphylococcal cassette chromosome mec integrated in the chromosome in methicillin-resistant Staphylococcus aureusAntimicrob Agents ChemotherAntimicrob Agents Chemother1323-36455Amino Acid Sequence*Bacterial ProteinsBase SequenceCarrier Proteins/*genetics*Chromosomes, BacterialEvolution, Molecular*HexosyltransferasesHumansMethicillin Resistance/*geneticsMolecular Sequence DataMuramoylpentapeptide Carboxypeptidase/*geneticsMutagenesis, InsertionalPenicillin-Binding Proteins*Peptidyl TransferasesPhylogenyPlant Proteins/classification/geneticsResearch Support, Non-U.S. Gov'tRestriction MappingSequence Homology, Amino AcidSequence Homology, Nucleic AcidStaphylococcus aureus/*genetics2001May11302791http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=11302791 Ito2004141417Ito, T.Ma, X. X.Takeuchi, F.Okuma, K.Yuzawa, H.Hiramatsu, K.Department of Bacteriology, Faculty of Medicine, Juntendo University, 2-1-1 Hongo, Bunkyo-ku, Tokyo, Japan. teruybac@med.juntendo.ac.jpNovel type V staphylococcal cassette chromosome mec driven by a novel cassette chromosome recombinase, ccrCAntimicrob Agents ChemotherAntimicrob Agents Chemother2637-51487Amino Acid Sequence*Bacterial ProteinsBase SequenceChromosomes, Bacterial/*geneticsDNA PrimersDNA Transposable Elements/geneticsDNA, Bacterial/geneticsMethicillin ResistanceMolecular Sequence DataOpen Reading Frames/geneticsPhylogenyPlasmids/geneticsRecombinases/*genetics/*metabolismRecombination, GeneticReverse Transcriptase Polymerase Chain ReactionStaphylococcus aureus/*genetics2004Jul15215121http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=15215121 (9, 11, 12).
SCCmec t a k o e r s a d r ~i u s e b i i n s e r c i j s k e s e k v e n c i j e , k a o at o j e I S 4 3 1 A D D I N E N . C I T E < E n d N o t e > < C i t e > < A u t h o r > K a t a y a m a < / A u t h o r > < Y e a r > 2 0 0 1 < / Y e a r > < R e c N u m > 2 7 < / R e c N u m > < r e c o r d > < r e c - n u m b e r > 2 7 < / r e c - n u m b e r > < r e f - t y p e n a m e = " J o u r n a l A r t i c l e " > 1 7 < / r e f - t y p e > < c o n t r i b u t o r s > < a u t h ors>Katayama, Y.Ito, T.Hiramatsu, K.Department of Bacteriology, Faculty of Medicine, Juntendo University, Tokyo, Japan.Genetic organization of the chromosome region surrounding mecA in clinical staphylococcal strains: role of IS431-mediated mecI deletion in expression of resistance in mecA-carrying, low-level methicillin-resistant Staphylococcus haemolyticusAntimicrob Agents ChemotherAntimicrob Agents Chemother1955-63457*Bacterial ProteinsCarrier Proteins/*genetics/metabolismChromosomes, BacterialDNA Transposable Elements/geneticsGene Deletion*Genome, Bacterial*HexosyltransferasesHumansMethicillin Resistance/*geneticsMuramoylpentapeptide Carboxypeptidase/*genetics/metabolismPenicillin-Binding Proteins*Peptidyl TransferasesRepressor Proteins/*geneticsResearch Support, Non-U.S. Gov'tStaphylococcus/*geneticsTranscription, Genetic2001Jul11408208http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=11408208 (13).
U ekspresiji rezistencije na meticilin sudjeluju i geni fem (engl. factor essential for the expression of methicillin resistance) i aux (engl. auxillary). N a j z n a
a j n i j e m j e s t o m e u n j i m a z a u z i m a f e m A B
i j a i n a k t i v a c i j a d j e l u j e n a s m a n j e n j e e k s p r e s i j e m e c A g e n a A D D I N E N . C I T E < E n d N o t e > < C i t e > < A u t h o r > C a r b o n < / A u t h o r > < Y e a r > 2 0 0 0 < / Y e a r > < R e c N u m > 4 2 0 < / R e c N u m > < r e c o r d > < r e c - n u m b e r > 4 2 0 < / r e c - n u m b e r > < r e f - t y p e n a m e = " J o u r n a l Article">17<style face="normal" font="default" charset="238" size="100%">MRSA and MRSE: is there an answer</style><style face="normal" font="default" size="100%">
</style>Clin Microbiol Infect(14).
Osim M R S A s o j e v a , k o j i s u d e f i n i r a n i p r i s u t n o au m e c A g e n a , p o s t o j e i z o l a t i k o j i p o k a z u j u s m a n j e n u o s j e t l j i v o s t n a s e m i s i n t e t s k e p e i n c i l i n s k e a n t i b i o t i k e z b o g h i p e r p r o d u k c i j e - l a k t a m a z a A D D I N E N . C I T E < E n d N o t e > < C i t e > < A u t h o r > M a s s i d a < / A u t h o r > < Y e a r > 1 9 9 2 < / Y e a r > < RecNum>42142117<style face="normal" font="default" charset="238" size="100%">Evidence for a methicillin-hidrolysing beta-lactamase in </style><style face="italic" font="default" charset="238" size="100%">Staphylococcus aureus</style><style face="normal" font="default" charset="238" size="100%"> strains using polymerase chain reaction </style>FEMS Microbiol Lett(15). Testom disk-difuzije ti se sojevi ne mogu razlikovati od MRSA. Minimalne inhibitorne koncentracije oksacilina za takve sojeve n i k a d n i s u v e e d o 1 2 , 5 m g / L , s t o g a s e n a z i v a j u g r a n i
n o r e z i s t e n t n i m a ( e n g l . b o r d e r l i n e o x a c i l l i n r e s i s t a n t S . a u r e u s , s k r a e n o B O R S A ) A D D I N E N . C I T E < E n d N o t e > < C i t e > < A u t h o r > H i r a m a t s u < / A u t h o r > < Y e a r > 1 9 9 2 < / Y e a r > < R e c N u m > 4 2 2 < / R e c N u m > < r e c o r d > < r e c - n u m b e r > 4 2 2 < / r e c-number>17<style face="normal" font="default" charset="238" size="100%">Analysis of borderline-resistant strains of methicillin-resistant </style><style face="italic" font="default" charset="238" size="100%">Staphylococcus aureus</style><style face="normal" font="default" charset="238" size="100%"> using polymerase chain reaction</style>Microbiol Immunol(16).
Podrijetlo mecA i SCCmec gena
Osim S. aureus, i koagulaza-negativni ADDIN EN.CITE CoNS917Ma, X. X.Galiana, A.Pedreira, W.Mowszowicz, M.Christophersen, I.Machiavello, S.Lope, L.Benaderet, S.Buela, F.Vincentino, W.Albini, M.Bertaux, O.Constenla, I.Bagnulo, H.Llosa, L.Ito, T.Hiramatsu, K.Juntendo University, Tokyo, Japan.Community-acquired methicillin-resistant Staphylococcus aureus, UruguayEmerg Infect DisEmerg Infect Dis973-6116Adhesins, Bacterial/geneticsAdultAnti-Bacterial Agents/pharmacologyCommunity-Acquired Infections/*epidemiology/microbiology/mortality*Disease Outbreaks*Drug Resistance, Multiple, Bacterial/geneticsHumansLeukocidins/genetics*Methicillin ResistanceMicrobial Sensitivity TestsMiddle AgedResearch Support, Non-U.S. Gov'tStaphylococcal Infections/*epidemiology/microbiology/mortalityStaphylococcus aureus/*drug effects/genetics/pathogenicityUruguay/epidemiology2005Jun15963301http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=15963301 (17) stafilokoki mogu sadr ~a v a t i S C C m e c . S p e k u l i r a s e d a j e S C C m e c d o s p i o u S . a u r e u s h o r i z o n t a l n i m t r a n s f e r o m i z k o a g u l a z a - n e g a t i v n i h s t a f i l o k o k a A D D I N E N . C I T E < E n d N o t e > < C i t e > < A u t h o r > M o n g k o l r a t t a n o t h a i < / A u t h o r > < Y e a r > 2 0 0 4 < / Y e a r > < R e c N u m > 8 1 < / R e c N u m > < r e c o r d > < r e c - n u m b e r > 8 1 < / r e c - n u m b e r >17Mongkolrattanothai, K.Boyle, S.Murphy, T. V.Daum, R. S.Section of Pediatric Infectious Diseases, Department of Pediatrics, University of Chicago, Chicago, Illinois 60637, USA.Novel non-mecA-containing staphylococcal chromosomal cassette composite island containing pbp4 and tagF genes in a commensal staphylococcal species: a possible reservoir for antibiotic resistance islands in Staphylococcus aureusAntimicrob Agents ChemotherAntimicrob Agents Chemother1823-36485Amino Acid SequenceBacterial Proteins/*geneticsBase SequenceCarrier Proteins/*geneticsChildChromosomes, Bacterial/*geneticsDNA, Bacterial/geneticsDrug Resistance, Bacterial/*geneticsHexosyltransferases/*geneticsHumansMethicillin Resistance/geneticsMolecular Sequence DataMultigene Family/geneticsMuramoylpentapeptide Carboxypeptidase/*geneticsPenicillin-Binding ProteinsPeptidyl Transferases/*geneticsPolymorphism, Restriction Fragment LengthPregnancy Proteins/*geneticsRecombination, GeneticRepetitive Sequences, Nucleic AcidResearch Support, Non-U.S. Gov'tResearch Support, U.S. Gov't, P.H.S.Reverse Transcriptase Polymerase Chain ReactionStaphylococcal Infections/microbiologyStaphylococcus/drug effects/*geneticsStaphylococcus aureus/drug effects/geneticsStaphylococcus epidermidis/drug effects/geneticsTransferases (Other Substituted Phosphate Groups)/*genetics2004May15105141http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=15105141 (18 ) . N a j v e u h o m o l o g n o s t s m e c A g e n o m n a l a z i m o u g e n e t s k o m e l e m e n t u ~i v o t i n j s k e k o m e n z a l n e b a k t e r i j e S t a p h y l o c o c c u s s c i u r i A D D I N E N . C I T E < E n d N o t e > < C i t e > < A u t h o r > C o u t o < / A u t h o r > < Y e a r > 2 0 0 3 < / Y e a r > < R e c N u m > 3 9 0 < / R e c N u m > < r e c o r d > < r e c - n u m b e r > 3 9 0 < / r e c - n u m b e r > < r e f - t y pe name="Journal Article">17<style face="normal" font="default" charset="238" size="100%">Development of methicillin-resistance in clinical isolates of Staphylococcus sciuri by transcriptional activation of the mecA homologue native to the species</style>J Bacteriol(19), koja posjeduje genetski element koji kodira PBP koji ima 87,8% homologije s PBP 2a. Izolati S. sciuri su uglavnom osjetljivi na meticilin, ali rastom u mediju u kojem se nalazi meticilin, postaju re z i s t e n t n i n a m e t i c i l i n , b i l o d a j e r i j e
o p o v e a n o j t r a n s k r i p c i j i m e c A h o m o l o g a i l i t o
k a s t o j m u t a c i j i p r o m o t o r a A D D I N E N . C I T E < E n d N o t e > < C i t e > < A u t h o r > W u < / A u t h o r > < Y e a r > 2 0 0 1 < / Y e a r > < R e c N u m > 8 5 < / R e c N u m > < r e c o r d > < r e c - n u m b e r > 8 5 < / r e c - n u m b e r > < r e f - t y p e n a m e = " J o u r nal Article">17Wu, S. W.de Lencastre, H.Tomasz, A.Laboratory of Microbiology, The Rockefeller University, New York, New York 10021, USA.Recruitment of the mecA gene homologue of Staphylococcus sciuri into a resistance determinant and expression of the resistant phenotype in Staphylococcus aureusJ BacteriolJ Bacteriol2417-241838Anti-Bacterial Agents/pharmacology*Bacterial ProteinsBlotting, WesternCarrier Proteins/*genetics/metabolismGenes, Bacterial*HexosyltransferasesLactams/pharmacologyMethicillin Resistance/*geneticsMicrobial Sensitivity TestsMuramoylpentapeptide Carboxypeptidase/*genetics/metabolismMutationPenicillin-Binding Proteins*Peptidyl TransferasesPhenotypeResearch Support, Non-U.S. Gov'tResearch Support, U.S. Gov't, P.H.S.Staphylococcus/*drug effects/geneticsStaphylococcus aureus/*drug effects/genetics/*metabolismTranscription, GeneticTransduction, Genetic2001Apr11274099http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=11274099 (20).
Postoje izvjetaji koji govore u prilog in vivo transferu SCCmec k r o m o s o m s k o g d i j e l a i z m e u i z o g e n i h M S S A i M R S A i z o l a t a A D D I N E N . C I T E < E n d N o t e > < C i t e > < A u t h o r > M o n g k o l r a t t a n o t h a i < / A u t h o r > < Y e a r > 2 0 0 3 < / Y e a r > < R e c N u m > 2 9 4 < / R e c N u m > < r e c o r d > < r e c - n u m b e r > 2 9 4 < / r e c - n u m b e r > < r e f - t y p e n a m e = " J o u r n a l A r t i c l e " > 1 7 < / r e f - t y p e > < c o n t r i b u t o r s > Mongkolrattanothai, K.Boyle, S.Kahana, M. D.Daum, R. S.Section of Pediatric Infectious Diseases, University of Chicago, Department of Pediatrics, Chicago, Illinois 60637, USA.Severe Staphylococcus aureus infections caused by clonally related community-acquired methicillin-susceptible and methicillin-resistant isolatesClin Infect DisClin Infect Dis1050-8378AdolescentAdultChildChild, PreschoolCommunity-Acquired Infections/*microbiologyFemaleHumansInfantMaleMethicillin/*pharmacologyMethicillin Resistance/*geneticsMicrobial Sensitivity TestsStaphylococcal Infections/*microbiologyStaphylococcus aureus/*drug effects/genetics2003Oct 1514523769http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=14523769 (21).
Z a b i l j e ~e n j e i i n v i v o t r a n s f e r S C C m e c u n o v o r o e n
e t a u N i z o z e m s k o j . N a k o n i z o l a c i j e M S S A u i s t o g d j e t e t a j e n a e n i z o g e n i M R S A
i j i m e c A g e n j e b i o i d e n t i
a n m e c A g e n u i z S t a p h y l o c o c c u s e p i d e r m i d i s i z o l i r a n o g o d i s t o g b o l e s n i k a A D D I N E N . C I T E < E n d N o t e>Wielders2001868617Wielders, C. L.Vriens, M. R.Brisse, S.de Graaf-Miltenburg, L. A.Troelstra, A.Fleer, A.Schmitz, F. J.Verhoef, J.Fluit, A. C.In-vivo transfer of mecA DNA to Staphylococcus aureus [corrected]LancetLancet1674-53579269Bacteremia/microbiology*Bacterial ProteinsCarrier Proteins/*geneticsCross Infection/microbiologyDNA FingerprintingDNA, Bacterial/*geneticsGene Transfer, Horizontal/*geneticsGenotype*HexosyltransferasesHumansInfant, NewbornMaleMicrobial Sensitivity TestsMuramoylpentapeptide Carboxypeptidase/*geneticsPenicillin-Binding Proteins*Peptidyl TransferasesStaphylococcal Infections/microbiologyStaphylococcus aureus/*genetics2001May 2611425376http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=11425376 (22).
Epidemiologija Staphylococcus aureus rezistentnih na meticilin (MRSA)
Staphylococcus aureus r e z i s t e n t a n n a m e t i c i l i n p r v i p u t s e p o j a v i o m e u b o l n i
k i m i z o l a t i m a 1 9 6 1 . g o d i n e A D D I N E N . C I T E < E n d N o t e > < C i t e > < A u t h o r > J e v o n s < / A u t h o r > < Y e a r > 1 9 6 1 < / Y e a r > < R e c N u m > 3 3 1 < / R e c N u m > < r e c o r d > < r e c - n u m b e r > 3 3 1 < / r e c - n u m b e r > < r e f - t y p e n a m e = " J o u r n a l A r t i c l e " > 1 7 < / r e f - t y p e ><style face="normal" font="default" charset="238" size="100%">"Celbenin" -resistant staphylococci</style>Bmj(23) kao izolat iz krvi. Prvi MRSA izolat, porijeklom iz 1961. godine iz Velike Britanije, imao je SCCmec I i t i p i
n i j e p r e d s t a v n i k A r h a i
n o g k l o n a k o j i s e p r o ai r i o s v i j e t o m u ae z d e s e t i m g o d i n a m a . M e t i c i l i n , i z v o r n o g n a z i v a c e l b e n i n j e u v e d e n u t e r a p i j u u E u r o p i 1 9 5 9 . - 1 9 6 0 . g o d i n e . I a k o s e m e t i c i l i n n e u p o t r e b l j a v a v i ae u t e r a p i j i s t a f i l o k o k n i h i n f e k c i j a , a k r o n i m M R S A j e o s t a o a o d n o s i s e n a S t a p h y l o c o c c u s a u r e u s k o j i j e r e z i s t e n t a n n a s v e b a t a - l a k t a m s k e a n t i b i o t i k e , u k l j u
u j u i c e f a l o s p o r i n e i k a r b a p e n e m e . P r v a M R S A e p i d e m i j a j e o p i s a n a 1 9 6 3 . g o d i n e A D D I N E N . C I T E < E n d N o t e > < C i t e > < A u t h o r > S t e w a r t < / A u t h o r > 196328728717Stewart, G. T.Holt, R. J.<style face="normal" font="default" size="100%">Evolutio</style><style face="normal" font="default" charset="238" size="100%">n</style><style face="normal" font="default" size="100%"> of natural resistance to the newer penicillins</style>Br Med JBr Med J308-1115326*Drug Resistance, Microbial*Methicillin*Penicillin G*Penicillins*Staphylococcal Infections1963Feb 213984091http://www.ncbi.nlm.nih.g o v / e n t r e z / q u e r y . f c g i ? c m d = R e t r i e v e & a m p ; d b = P u b M e d & a m p ; d o p t = C i t a t i o n & a m p ; l i s t _ u i d s = 1 3 9 8 4 0 9 1 < / u r l > < / r e l a t e d - u r l s > < / u r l s > < / r e c o r d > < / C i t e > < / E n d N o t e > ( 2 4 ) .
O d ae z d e s e t i h g o d i n a M R S A s o j e v i s u s e p r o ai r i l i m e u e u r o p s k i m b o l n i c a m a . S e d a m d e s e t i h j e i u S A D z a b i l j e ~e n a p o j a v a M R S A i z o l a t a k a o i u J a p a n u i A u s t r a l i j i . 1 9 8 2 . g o d i n e M R S A S C C m e c t i p a I I j e o t k r i v e n u J a p a n u i N e w Y o r k / J a p a n k l o n k o j e m p r i p a d a s e t a k o e r p r o ai r i o , n a k o n
e g a s l i j e d i i z o l a c i j a M R S A s o j a S C C m e c t i p a I I I n a N o v o m Z e l a n d u . P r v i M R S A i z o l a t i S C C m e c t i p a I V p o j a v i l i s u s e u d e v e d e s e t i m g o d i n a m a p r o al o g s t o l j e a u S A D . U A u s t r a l i j i j e 2 0 0 0 . p r o n a e n p r v i i z o l a t S C C m e c t i p a V A D D I N E N . C I T E < E n d N o t e > < C i t e E x c l u d e Y e a r = " 1 " > < A u t h o r > W I S < / A u t h o r > < r e c o r d > < r e c - n u m b e r > 1 1 8 < / r e c - n u m b e r > < r e f - t y p e n a m e = "Journal Article">17Wisplinghoff, H.Rosato, A. E.Enright, M. C.Noto, M.Craig, W.Archer, G. L.Division of Infectious Diseases, Department of Internal Medicine, Virginia Commonwealth University, Richmond, Virginia 23292, USA.Related clones containing SCCmec type IV predominate among clinically significant Staphylococcus epidermidis isolatesAntimicrob Agents Chemother3574-94711AllelesBacterial Proteins/*geneticsDNA PrimersGenotypeMethicillin ResistanceResearch Support, U.S. Gov't, P.H.S.Reverse Transcriptase Polymerase Chain ReactionStaphylococcal Infections/*microbiologyStaphylococcus epidermidis/*genetics2003Nov14576120http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=14576120 (25).
Danas je MRSA jedan o d n a j
e ai h u z r o
n i k a b a k t e r i j s k i h n o z o k o m i j a l n i h i n f e k c i j a , u z r o k u j u i 4 0 - 7 0 % S t a p h y l o c o c c u s a u r e u s i n f e k c i j a u j e d i n i c a m a i n t e n z i v n e n j e g e A D D I N E N . C I T E < E n d N o t e > < C i t e > < A u t h o r > D i e k e m a < / A u t h o r > < Y e a r > 2 0 0 1 < / Y e a r > < R e c N u m > 1 9 3 < / R e c N u m > < r e c o r d > < r e c - n u m b e r > 1 9 3 17Diekema, D. J.Pfaller, M. A.Schmitz, F. J.Smayevsky, J.Bell, J.Jones, R. N.Beach, M.Medical Microbiology Division, Department of Pathology, University of Iowa College of Medicine, Iowa City, Iowa 52242, USA. daniel-diekema@uiowa.eduSurvey of infections due to Staphylococcus species: frequency of occurrence and antimicrobial susceptibility of isolates collected in the United States, Canada, Latin America, Europe, and the Western Pacific region for the SENTRY Antimicrobial Surveillance Program, 1997-1999Clin Infect DisClin Infect DisS114-3232 Suppl 2Anti-Bacterial Agents/therapeutic useCanada/epidemiologyDrug Resistance, MicrobialEurope/epidemiologyFar East/epidemiologyHumansLatin America/epidemiologyMethicillin ResistanceMicrobial Sensitivity TestsStaphylococcal Infections/drug therapy/*epidemiologyUnited States/epidemiology2001May 1511320452http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=11320452 (26). U Hrvatsk o j j e p r v o i z v j e ae o z n a
e n j u M R S A s o j e v a o b j a v l j e n o 1 9 9 7 . g o d i n e A D D I N E N . C I T E < E n d N o t e > < C i t e > < A u t h o r > T a m b i c < / A u t h o r > < Y e a r > 1 9 9 7 < / Y e a r > < R e c N u m > 4 3 5 < / R e c N u m > < r e c o r d > < r e c - n u m b e r > 4 3 5 < / r e c - n u m b e r > < r e f - t y p e n a m e = " J o u r n a l A r t i c l e " > 1 7 < / r e f - t y p e > < c o n t r i b u t o r s > < a uthors><style face="normal" font="default" charset="238" size="100%">Meticilin-rezistentni </style><style face="italic" font="default" charset="238" size="100%">Staphylococcus aureus</sty l e > < s t y l e f a c e = " n o r m a l " f o n t = " d e f a u l t " c h a r s e t = " 2 3 8 " s i z e = " 1 0 0 % " > ( M R S A ) , p r e d i k t o r k r a j a a n t i b i o t s k e e r e - d i j a g n o z a , e p i d e m i o l o g i j a , t e r a p i j a i s p r e
a v a n j e ai r e n j a < / s t y l e > < / t i t l e > < s e c o n d a r y - t i t l e > < s t y l e f a c e = " n o r m a l " f o n t = " d e f a u l t " c h a r s e t = " 2 3 8 " s i z e = " 1 0 0 % " > L i j e
V j e s n < / s t y l e > < / s e c o n d a r y - t i t l e > < / t i t l e s > < p e r i o d i c a l > < f u l l - t i t l e > L i j e
V j e s n < / f u l l - t i t l e > < / p e r i o d i c a l > < p a g e s > < s t y l e f a c e = " n o r m a l " f o n t = " d e f a u l t " c h a r s e t = " 2 3 8 " s i z e = " 1 0 0 % " > 1 6 6 - 7 1 < / s t y l e > < / p a g e s > < v o l u m e > < s t y l e f a c e = " n o r m a l " f o n t = " d e f a u l t " c h a r s e t = " 2 3 8 " size="100%">119</style></volume><dates><year><style face="normal" font="default" charset="238" size="100%">1997</style></year></dates><urls></urls></record></Cite></EndNote>(27).
Podaci o prevalenciji MRSA izolata razlikuju se u raznim dijelovima svijeta kao i m e u b o l n i c a m a i i z n o s e o d 0 , 6 % u N o r v e ak o j d o 6 6 , 8 % u J a p a n u , at o j e p r i k a z a n o u T a b l i c i 1 .
T a b l i c a 1 . P r e v a l e n c i j a M R S A i z o l a t a i z h e m o k u l t u r a
D r ~a v a
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L e g e nda: 1 podaci dobiveni iz EARSS interaktivne baze na HYPERLINK "http://www.earss.com" www.earss.com
2 podaci dobiveni iz SENTRY studije ADDIN EN.CITE <EndNote><Cite><Author>Diekema</Author><Year>2001</Year><RecNum>193</RecNum><record><rec-number>193</rec-number><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Diekema, D. J.</author><author>Pfaller, M. A.</author><author>Schmitz, F. J.</author><author>Smayevsky, J.</author><author>Bell, J.</author><author>Jones, R. N.</author><author>Beach, M.</author></authors></contributors><auth-address>Medical Microbiology Division, Department of Pathology, University of Iowa College of Medicine, Iowa City, Iowa 52242, USA. daniel-diekema@uiowa.edu</auth-address><titles><title>Survey of infections due to Staphylococcus species: frequency of occurrence and antimicrobial susceptibility of isolates collected in the United States, Canada, Latin America, Europe, and the Western Pacific region for the SENTRY Antimicrobial Surveillance Program, 1997-1999Clin Infect DisClin Infect DisS114-3232 Suppl 2Anti-Bacterial Agents/therapeutic useCanada/epidemiologyDrug Resistance, MicrobialEurope/epidemiologyFar East/epidemiologyHumansLatin America/epidemiologyMethicillin ResistanceMicrobial Sensitivity TestsStaphylococcal Infections/drug therapy/*epidemiologyUnited States/epidemiology2001May 1511320452http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=11320452 ( 2 6 )
U H r v a t s k o j j e 2 0 0 5 . g o d i n e p o s t o t a k M R S A m e u S . a u r e u s i z o l a t i m a i z n o s i o 1 9 , 9 8 % u A D D I N E N . C I T E < E n d N o t e > < C i t e > < A u t h o r > T a m b i c A n d r a ae v i c < / A u t h o r > < Y e a r > 2 0 0 6 < / Y e a r > < R e c N u m > 4 3 4 < / R e c N u m > < r e c o r d > < r e c - n u m b e r > 4 3 4 < / r e c - n u m b e r > < r e f - t y p e n a m e = " R e p o r t " > 2 7 < / ref-type><style face="normal" font="default" charset="238" size="100%">Osjetljivost i rezistencija bakterija na antibiotike u Republici Hrvatskoj u 2005. godini</style>MMWR Morb Mortal Wkly Rep200441041017<style face="normal" font="default" charset="238" size="100%">From the Centers for Disease Control and Prevention.Community-Associated Methicillin-Resistant Staphylococcus aureus Infection Among Healty Newborns-Chicago and Los Angeles County</style>MMWR Morb Mortal Wkly RepZaoutis200640440417Zaoutis, T. E.Toltzis, P.Chu, J.Abrams, T.Dul, M.Kim, J.McGowan, K. L.Coffin, S. E.Division of Infectious Diseases , Children's Hospital of Philadelphia, PA, USA. zaoutis@email.chop.eduClinical and molecular epidemiology of community-acquired methicillin-resistant Staphylococcus aureus infections among children with risk factors for health care-associated infection: 2001-2003Pediatr Infect Dis JPediatr Infect Dis J343-8254ChildChild, PreschoolCommunity-Acquired Infections/*epidemiology/microbiologyCross Infection/*epidemiology/microbiologyEpidemiology, MolecularHumansInfant*Methicillin ResistanceResearch Support, N.I.H., ExtramuralResearch Support, Non-U.S. Gov'tRisk FactorsStaphylococcal Infections/*epidemiology/microbiologyStaphylococcus aureus/classification/*drug effects/genetics/isolation &purification2006Apr16567987http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=16567987 ( 3 7 , 3 8 ) . I n f e k c i j e k o j e i z v a n b o l n i
k i M R S A u z r o k u j u o b i
n o s u t e ak e k o ~n e i n f e k c i j e ( c e l u l i t i s , n e k r o t i z i r a j u i f a s c i i t i s ) i n e k r o t i z i r a j u e p n e u m o n i j e A D D I N E N . C I T E < E n d N o t e > < C i t e > < A u t h o r > N a i m i < / A u t h o r > < Y e a r > 2 0 0 3 < / Y e a r > < R e c N u m > 1 7 0 < / R e c N u m > < r e c o rd>17017Naimi, T. S.LeDell, K. H.Como-Sabetti, K.Borchardt, S. M.Boxrud, D. J.Etienne, J.Johnson, S. K.Vandenesch, F.Fridkin, S.O'Boyle, C.Danila, R. N.Lynfield, R.Acute Disease Investigation and Control Section, Minnesota Department of Health, Minneapolis, USA. tbn7@cdc.govComparison of community- and health care-associated methicillin-resistant Staphylococcus aureus infectionJamaJama2976-8429022AdultAgedCohort StudiesCommunity-Acquired Infections/*epidemiology/microbiologyComparative StudyCross Infection/*epidemiology/microbiologyElectrophoresis, Gel, Pulsed-FieldHumans*Methicillin ResistanceMicrobial Sensitivity TestsMiddle AgedMinnesota/epidemiologyResearch Support, Non-U.S. Gov'tResearch Support, U.S. Gov't, Non-P.H.S.Research Support, U.S. Gov't, P.H.S.Staphylococcal Infections/*epidemiology/*microbiologyStaphylococcus aureus/*drug effects/genetics2003Dec 1014665659http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=14665659 ( 3 9 ) .
I z v a n b o l n i
k e M R S A i z o l a t e k a r a k t e r i z i r a p o s j e d o v a n j e S C C m e c t i p a I V i V A D D I N E N . C I T E < E n d N o t e > < C i t e > < A u t h o r > I t o < / A u t h o r > < Y e a r > 2 0 0 3 < / Y e a r > < R e c N u m > 1 7 < / R e c N u m > < r e c o r d > < r e c - n u m b e r > 1 7 < / r e c - n u m b e r > < r e f - t y p e n a m e = " J o u r n a l A r t i c l e " > 1 7 < / r e f - t y p e > < contributors>Ito, T.Okuma, K.Ma, X. X.Yuzawa, H.Hiramatsu, K.Department of Bacteriology, Juntendo University, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan. teruybac@med.juntendo.ac.jpInsights on antibiotic resistance of Staphylococcus aureus from its whole genome: genomic island SCCDrug Resist UpdatDrug Resist Updat41-5261Community-Acquired Infections/drug therapy/microbiologyCross Infection/drug therapy/microbiologyDNA Transposable ElementsDrug Resistance, Bacterial/*geneticsDrug Resistance, Multiple, Bacterial/genetics*Genome, BacterialMethicillin Resistance/geneticsMutationStaphylococcal Infections/drug therapy/microbiologyStaphylococcus aureus/drug effects/*genetics2003Feb12654286http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=12654286 Ito2004141417Ito, T.Ma, X. X.Takeuchi, F.Okuma, K.Yuzawa, H.Hiramatsu, K.Department of Bacteriology, Faculty of Medicine, Juntendo University, 2-1-1 Hongo, Bunkyo-ku, Tokyo, Japan. teruybac@med.juntendo.ac.jpNovel type V staphylococcal cassette chromosome mec driven by a novel cassette chromosome recombinase, ccrCAntimicrob Agents ChemotherAntimicrob Agents Chemother2637-51487Amino Acid Sequence*Bacterial ProteinsBase SequenceChromosomes, Bacterial/*geneticsDNA PrimersDNA Transposable Elements/geneticsDNA, Bacterial/geneticsMethicillin ResistanceMolecular Sequence DataOpen Reading Frames/geneticsPhylogenyPlasmids/geneticsRecombinases/*genetics/*metabolismRecombination, GeneticReverse Transcriptase Polymerase Chain ReactionStaphylococcus aureus/*genetics2004Jul15215121http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=15215121 (9, 12) kod kojih su SCCmec k a s e t e m a n j e n e g o k o d b o l n i
k i h S C C m e c t i p o v a I , I I I I I I . M a n j a k o l i
i n a g e n e t s k o g m a t e r i j a l a , v e a v i r u l e n c i j a , b r ~i r a s t u o d n o s u n a b o l n i
k e M R S A A D D I N E N . C I T E < E n d N o t e > < C i t e > < A u t h o r > O k u m a < / A u t h o r > < Y e a r > 2 0 0 2 < / Y e a r > < R e c N u m > 1 8 < / R e c N u m > < r e c o r d > < r e c - n u m ber>1817Okuma, K.Iwakawa, K.Turnidge, J. D.Grubb, W. B.Bell, J. M.O'Brien, F. G.Coombs, G. W.Pearman, J. W.Tenover, F. C.Kapi, M.Tiensasitorn, C.Ito, T.Hiramatsu, K.Department of Bacteriology, Juntendo University, Tokyo, Japan. hiram@med.juntendo.ac.jpDissemination of new methicillin-resistant Staphylococcus aureus clones in the communityJ Clin MicrobiolJ Clin Microbiol4289-944011Anti-Bacterial Agents/pharmacologyAustralia/epidemiologyCommunity-Acquired Infections/*epidemiology/microbiologyHumansMethicillin Resistance/*geneticsMicrobial Sensitivity TestsResearch Support, Non-U.S. Gov'tStaphylococcal Infections/*epidemiology/microbiologyStaphylococcus aureus/classification/*drug effects/*genetics/growth &developmentUnited States/epidemiology2002Nov12409412http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=12409412 (40), kao i bolja prilagodljivost dom a i n u ,
i n i i z v a n b o l n i
k e M R S A i z n i m n o v a ~n i m a .
O p i s a n i s u i b o l n i
k i M R S A s o j e v i S C C m e c t i p a I V , t a k o d a t a j p o d a t a k n i j e d o v o l j a n d a b i s e s o j s m a t r a o i z v a n b o l n i
k i m M R S A s o j e m . S t o g a s e r a z l i
i t i m d e f i n i c i j a m a p o k u aa l o j a s n o o d i j e l i t i i z v a n b o l n i
k e M R S A o d b o l n i
k i h M R S A s o j e v a A D D I N E N . C I T E < E n d N o t e > < C i t e > < A u t h o r > S a l g a d o < / A u t h o r > < Y e a r > 2 0 0 3 < / Y e a r > < R e c N u m > 3 0 1 < / R e c N u m > < r e c o r d > < r e c - n u m b e r > 3 0 1 < / r e c - n u m b e r > < r e f - t y p e n a m e = " J o u r n a l A r t i c l e " > 1 7 < / r e f - t y p e > < c o n t r i b u t o r s > < a u t h o r s > < a u t h o r > S a l g a d o , C . D . < / a u t h o r > Farr, B. M.Calfee, D. P.University of Virginia Health System, Charlottesville, VA 22908, USA.Community-acquired methicillin-resistant Staphylococcus aureus: a meta-analysis of prevalence and risk factorsClin Infect DisClin Infect Dis131-9362Community-Acquired Infections/*epidemiology/microbiologyCross Infection/microbiologyHumansMeta-Analysis*Methicillin ResistancePrevalenceRisk FactorsStaphylococcal Infections/*epidemiology/microbiology*Staphylococcus aureus2003Jan 1512522744http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=12522744 (41).
Centar za kontrolu i prevenciju bolesti (CDC) iz Atlant e , S A D , d e f i n i r a i z v a n b o l n i
k e M R S A k a o s o j e v e i z o l i r a n e u b o l e s n i k a k o j i n i s u h o s p i t a l i t z i r a n i , i l i u h o s p i t a l i z i r a n i h b o l e s n i k a u n u t a r 4 8 s a t i o d p r i j e m a u b o l n i c u . N a d a l j e , p o d e f i n i c i j i s e i s k l j u
u j u i z o l a t i u b o l e s n i k a k o j i s u i m a l i p r e t h o d n o d o k u m e n t i r a n u M R S A k o l o n i z a c i j u , b o r a v a k u b o l n i c i u n a t r a g g o d i n u d a n a , k o j i b o r a v e u u s t a n o v i k r o n i
n o g t i p a , d i j a l i z i r a j u s e i l i s u b i l i o p e r i r a n i u n u t a r g o d i n e d a n a . P o d e f i n i c i j i s e t a k o e r n e u k l j u
u j u i z o l a t i b o l e s n i k a k o j i i m a j u t r a j n i k a t e t e r i l i p o m a g a l o k o j e n a r u aa v a i n t e g r i t e t k o ~e A D D I N E N . C I T E < E n d N o t e > < C i t e > < Y e a r > 2 0 0 5 < / Y e a r > < R e c N u m > 4 3 3 < / R e c N u m > < r e c o r d > < r e c - n u m b e r > 4 3 3 < / r e c - n u m b e r > < r e f - t y p e n a m e = " J o u r n a l A r t i c l e " > 1 7 < / r e f - t y p e > < c o n t r i b u t o r s > < / c o n t r i b u t o r s > < t i t l e s > < t i t l e > < s t y l e f a c e = " n o r m a l " f o n t = " d efault" charset="238" size="100%">Community-associated Methicillin-Resistant Staphylococcus aureus (CA-MRSA)<style face="normal" font="default" charset="238" size="100%">Community-acquired methicillin-resistant </style><style face="italic" font="default" charset="238" size="100%">Staphylococcus aureus</style><style face="normal" font="default" charset="238" size="100%"> infections: a new source for nosocomial outbreaks.</style>Ann Intern MedLevine198233233217<style face="normal" font="default" charset="238" size="100%">Community-acquired methicillin-resistant </style><style face="italic" font="default" charset="238" size="100%">Staphylococcus aureus </style><style face="normal" font="default" charset="238" size="100%">endocarditis in the Detroit Medical Center</style>Ann Intern Med(47, 48) p o
i n j e s e r a z m a t r a t i m o g u n o s t p o s t o j a n j a r e z e r v o a r a M R S A i u i z v a n b o l n i
k o m o k r u ~e n j u . P r v i s l u
a j e v i i z v a n b o l n i
k i h M R S A i n f e k c i j a o d n o s i l i s u s e n a i n t r a v e n s k e o v i s n i k e o d r o g a m a k o j i s u k o r i s t i l i i s t u i g l u i n a t a j n a
i n s e m e u s o b n o i n f i c i r a l i . P r v i i z v a n b o l n i
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1 9 9 8 . g o d i n e u S A D j e i s t r a ~i v a n a p r i s u t n o s t i z v a n b o l n i
k i h M R S A i z o l a t a u d j e c e k o j a s u s e j a v l j a l a l i j e
n i k u u a m b u l a n t e z b o g d r u g i h r a z l o g a , i n a e n a j e i n c i d e n c i j a o d 3 % u j e d n o j i 2 4 % u d r u g o j d j e
j o j b o l n i c i . I z o l a t i s u b i l i o s j e t l j i v i n a n e - b e t a l a k t a m s k e a n t i b i o t i k e a v i ae o d 4 0 % d j e c e n i j e i m a l o d i r e k t n e i l i i n d i r e k t n e p o v e z a n o s t i s b o l n i
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k i m M R S A s o j e m t i j e k o m r a z d o b l j a o d 1 9 9 0 . d o 1 9 9 7 . g o d i n e p o v e a o 2 5 p u t a A D D I N E N . C I T E < E n d N o t e > < C i t e > < A u t h o r > P u r c e l l < / A u t h o r > < Y e a r > 2 0 0 5 < / Y e a r > < R e c N u m > 3 4 7 34717<style face="normal" font="default" charset="238" size="100%">Epidemic of community- acquired methicillin- resistant Staphylococcus aureus infections: a 14-year study at Driscoll Childrens Hospital</style>Purcell200534734717<style face="normal" font="default" charset="238" size="100%">Epidemic of community- acquired methicillin- resistant Staphylococcus aureus infections: a 14-year study at Driscoll Childrens Hospital</style>Zaoutis200640440417Zaoutis, T. E.Toltzis, P.Chu, J.Abrams, T.Dul, M.Kim, J.McGowan, K. L.Coffin, S. E.Division of Infectious Diseases , Children's Hospital of Philadelphia, PA, USA. zaoutis@email.chop.eduClinical and molecular epidemiology of community-acquired methicillin-resistant Staphylococcus aureus infections among children with risk factors for health care-associated infection: 2001-2003Pediatr Infect Dis JPediatr Infect Dis J343-8254ChildChild, PreschoolCommunity-Acquired Infections/*epidemiology/microbiologyCross Infection/*epidemiology/microbiologyEpidemiology, MolecularHumansInfant*Methicillin ResistanceResearch Support, N.I.H., ExtramuralResearch Support, Non-U.S. Gov'tRisk FactorsStaphylococcal Infections/*epidemiology/microbiologyStaphylococcus aureus/classification/*drug effects/genetics/isolation &purification2006Apr16567987http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=16567987 (38, 51).
1999. godine
e t v o r o d j e c e i z M i n e s o t e i s j e v e r n e D a k o t e j e u m r l o n a k o n t e ak i h i n f e k c i j a u z r o k o v a n i h i z v a n b o l n i
k i m M R S A A D D I N E N . C I T E < E n d N o t e > < C i t e > < Y e a r > 1 9 9 9 < / Y e a r > < R e c N u m > 2 9 8 < / R e c N u m > < r e c o r d > < r e c - n u m b e r > 2 9 8 < / r e c - n u m b e r > < r e f - t y p e n a m e = " J o u r n a l A r t i c l e " > 1 7 < / r e f - t y p e>From the Centers for Disease Control and Prevention. Four pediatric deaths from community-acquired methicillin-resistant Staphylococcus aureus--Minnesota and North Dakota, 1997-1999JamaJama1123-528212AdolescentChildCommunity-Acquired Infections/microbiologyElectrophoresis, Gel, Pulsed-FieldFatal OutcomeFemaleHumansInfantMale*Methicillin ResistanceMinnesotaNorth DakotaPneumonia, Bacterial/microbiologySepsis Syndrome/microbiologyStaphylococcal Infections/*microbiologyStaphylococcus aureus/*drug effects/genetics1999Sep 22-2910501104http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=10501104 (52).
U E u r o p i s e p r v a i z v i j e aa o i z v a n b o l n i
k i m M R S A s p o m i n j u 2 0 0 1 . g o d i n e A D D I N E N . C I T E < E n d N o t e > < C i t e > < A u t h o r > S a l g a d o < / A u t h o r > < Y e a r > 2 0 0 3 < / Y e a r > < R e c N u m > 3 0 1 < / R e c N u m > < r e c o r d > < r e c - n u m b e r > 3 0 1 < / r e c - n u m b e r > < r e f - t y p e n a m e = " J o u r n a l A r t i c l e " > 1 7 < / r e f - t y p e > < c o n t r i b u t o rs>Salgado, C. D.Farr, B. M.Calfee, D. P.University of Virginia Health System, Charlottesville, VA 22908, USA.Community-acquired methicillin-resistant Staphylococcus aureus: a meta-analysis of prevalence and risk factorsClin Infect DisClin Infect Dis131-9362Community-Acquired Infections/*epidemiology/microbiologyCross Infection/microbiologyHumansMeta-Analysis*Methicillin ResistancePrevalenceRisk FactorsStaphylococcal Infections/*epidemiology/microbiology*Staphylococcus aureus2003Jan 1512522744http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=12522744 (41).
Analiza izva n b o l n i
k i h i b o l n i
k i h M R S A m e t o d o m e l e k t r o f o r e z e u p u l s i r a j u e m p o l j u ( P F G E ) , p o k a z a l e s u u p o
e t k u d a s u M R S A s o j e v i b i l i g e n e t s k i s l i
n i A D D I N E N . C I T E < E n d N o t e > < C i t e > < A u t h o r > J o h n s o n < / A u t h o r > < Y e a r > 2 0 0 3 < / Y e a r > < R e c N u m > 3 4 9 < / R e c N u m > < r e c o r d > < r e c - n u m b e r > 3 4 9 < /rec-number>17<style face="normal" font="default" charset="238" size="100%">Changing epidemiology of community-onset methicillin-resistant Staphylococcus aureus bacteremia. </style>Infect Control Hosp Epidemiol<style face="normal" font="default" charset="238" size="100%">Community-associated Methicillin-resistant </style><style face="italic" font="default" charset="238" size="100%">Staphylococcus aureus</style><style face="normal" font="default" charset="238" size="100%">, Canada</style>Emerg Infect Dis(61).
Osjetljivost na eritromicin varira od 10 do 100% ADDIN EN.CITE Eady200334834817<style face="normal" font="default" charset="238" size="100%">Staphylcoccal resistance revised: community-acquired methicillin-resistant </style><style face="italic" font="default" charset="238" size="100%">Staphylococcus aureus </style><style face="normal" font="default" charset="238" size="100%">-an emerging problem for the management of skin and soft tissue infections</style>Curr Opin Infect Dis(62) , o s j e t l j i v o s t n a k l i n d a m i c i n i z n o s i o d 8 0 d o 9 0 % , v e i n a i z v a n b o l n i
k i h M R S A j e o s j e t l j i v a n a c i p r o f l o k s a c i n , 9 5 % i z o l a t a j e o s j e t l j i v o n a s u l f a m e t o k s a z o l - t r i m e t o p r i m A D D I N E N . C I T E < E n d N o t e > < C i t e > < A u t h o r > E a d y < / A u t h o r > < Y e a r > 2 0 0 3 < / Y e a r > < R e c N u m > 3 4 8 < / R e c N u m>34817<style face="normal" font="default" charset="238" size="100%">Staphylcoccal resistance revised: community-acquired methicillin-resistant </style><style face="italic" font="default" charset="238" size="100%">Staphylococcus aureus </style><style face="normal" font="default" charset="238" size="100%">-an emerging problem for the management of skin and soft tissue infections</style>Curr Opin Infect Dis < y e a r > < s t y l e f a c e = " n o r m a l " f o n t = " d e f a u l t " c h a r s e t = " 2 3 8 " s i z e = " 1 0 0 % " > 2 0 0 3 < / s t y l e > < / y e a r > < / d a t e s > < u r l s > < / u r l s > < / r e c o r d > < / C i t e > < / E n d N o t e > ( 6 2 ) .
P r i l i k o m d e f i n i r a n j a i z v a n b o l n i
k i h M R S A p o s t o j i n e k o l i k o p r o b l e m a , b i l o d a s e r a d i o e p i d e m i o l o ak o j d e f i n i c i j i i l i g e n e t s k o j d e f i n i c i j i i z v a n b o l n i
k i h M R S A . U k o l i k o s e n e p r o v e d e m o l e k u l a r n a a n a l i z a s o j e v a , o d r e e n b r o j i z v a n b o l n i
k i h i z o l a t a m o ~e s e p r o g l a s i t i b o l n i
k i m a i o b r n u t o , j e r j e m o g u e d a , k o r i s t e i s e e p i d e m i o l o ak i m d e f i n i c i j a m a , b o l e s n i k k o j i b o r a v i u b o l n i c i d u l j e o d 4 8 s a t i , a k o j e k o l o n i z i r a n i z v a n b o l n i
k i m M R S A r a z v i j e i n f e k c i j u t i m s o j e m i , o b r n u t o , b o l e s n i k m o ~e b i t i i n f i c i r a n b o l n i
k i m M R S A s o j e m k o j i m g a j e k o l o n i z i r a o n e t k o i z k u a n s t v a , o k o l i n e , t k o j e b i o h o s p i t a l i z i r a n p r i j e v i ae g o d i n a i b i o d u g o t r a j n o k o l o n i z i r a n b o l n i
k i m M R S A s o j e m .
S C C m e c t i p I V u n e k i m z e m l j a m a A D D I N E N . C I T E < E n d N o t e > < C i t e > < A u t h o r > D a n c e r < / A u t h o r > < Y e a r > 2 0 0 6 < / Y e a r > < R e c N u m > 2 5 1 < / R e c N u m > < r e c o r d > < r e c - n u m b e r > 2 5 1 < / r e c - n u m b e r > < r e f - t y p e n a m e = " J o u r n a l A r t i c l e " > 1 7 < / r e f - t y p e >Dancer, S. J.Coyne, M.Speekenbrink, A.Samavedam, S.Kennedy, J.Wallace, P. G.Health Protection Scotland, Clifton House, Western Infirmary, Glasgow, Scotland. stephanie.dancer@sgh.scot.nhs.ukMRSA acquisition in an intensive care unitAm J Infect ControlAm J Infect Control10-7341Blood/microbiologyCross Infection/*epidemiology/microbiologyDNA FingerprintingDNA, Bacterial/analysis/isolation & purificationElectrophoresis, Gel, Pulsed-FieldEpidemiology, MolecularHand/microbiologyHumansInfection Control/methods*Intensive Care Units*Methicillin ResistanceNursing Staff, HospitalRetrospective StudiesStaphylococcal Infections/*epidemiology/microbiologyStaphylococcus aureus/classification/*drug effects/geneticsWorkload/statistics & numerical data2006Feb16443087http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=16443087 Hanssen2005737317Hanssen, A. M.Fossum, A.Mikalsen, J.Halvorsen, D. S.Bukholm, G.Sollid, J. U.Department for Microbiology and Virology, Faculty of Medicine, Institute of Medical Biology, University of Tromso, N-9037 Tromso, Norway. annemh@fagmed.uit.noDissemination of community-acquired methicillin-resistant Staphylococcus aureus clones in northern Norway: sequence types 8 and 80 predominateJ Clin MicrobiolJ Clin Microbiol2118-24435Community-Acquired Infections/epidemiology/microbiology/*transmissionEpidemiology, Molecular/methodsHumans*Methicillin ResistanceMicrobial Sensitivity TestsNorway/epidemiologyPhylogenyResearch Support, Non-U.S. Gov'tSerotypingStaphylococcal Infections/epidemiology/microbiology/*transmissionStaphylococcus aureus/classification/drug effects/genetics/*isolation &purification2005May15872230http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=15872230 (63, 64) je dominantan t i p b o l n i
k i h M R S A k o j i s e n a l a z i i u i z v a n b o l n i
k o j p o p u l a c i j i b e z r i z i
n i h f a k t o r a z a b o l n i
k e M R S A t a k o d a s e s m a t r a d a j e s m j e r ai r e n j a b i o i z z a j e d n i c e u b o l n i c e A D D I N E N . C I T E < E n d N o t e > < C i t e > < A u t h o r > W a n n e t < / A u t h o r > < Y e a r > 2 0 0 4 < / Y e a r > < R e c N u m > 7 4 < / R e c N u m>7417Wannet, W. J.Spalburg, E.Heck, M. E.Pluister, G. N.Willems, R. J.De Neeling, A. J.Diagnostic Laboratory for Infectious Diseases and Perinatal Screening, National Institute of Public Health and the Environment, P.O. Box 1, 3720 BA Bilthoven, The Netherlands. wim.wannet@rivm.nlWidespread dissemination in The Netherlands of the epidemic berlin methicillin-resistant Staphylococcus aureus clone with low-level resistance to oxacillinJ Clin MicrobiolJ Clin Microbiol3077-82427Drug Resistance, BacterialElectrophoresis, Gel, Pulsed-Field*Methicillin ResistanceNetherlandsOxacillin/*pharmacologyStaphylococcus aureus/*drug effects2004Jul15243063http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=15243063 (65) a ne obrnuto. SCCmec tip IV je t i p i
a n b o l n i
k i i z o l a t i u V e l i k o j B r i t a n i j i A D D I N E N . C I T E < E n d N o t e > < C i t e > < A u t h o r > D a u m < / A u t h o r > < Y e a r > 2 0 0 2 < / Y e a r > < R e c N u m > 1 9 < / R e c N u m > < r e c o r d > < r e c - n u m b e r > 1 9 < / r e c - n u m b e r > < r e f - t y p e n a m e = " J o u r n a l A r t i c l e " > 1 7 < / r e f - t y p e > < c o n t r i b u t o r s > < a u t h o r s > < a u t h o r > D a u m , R . S .Ito, T.Hiramatsu, K.Hussain, F.Mongkolrattanothai, K.Jamklang, M.Boyle-Vavra, S.Department of Pediatrics, University of Chicago, Chicago, Illinois 60637, USA. rdaum@peds.bsd.uchicago.eduA novel methicillin-resistance cassette in community-acquired methicillin-resistant Staphylococcus aureus isolates of diverse genetic backgroundsJ Infect DisJ Infect Dis1344-71869Community-Acquired Infections/*transmissionCross Infection/transmissionHumansMethicillin Resistance/*geneticsPolymerase Chain ReactionResearch Support, U.S. Gov't, P.H.S.Staphylococcal Infections/*transmissionStaphylococcus aureus/classification/drug effects/*genetics2002Nov 112402206http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=12402206 (66), gdje je poznat pod nazivom EMRSA-15, a i kao pedijatrijski klon u bolnicama irom svijeta ADDIN EN.CITE Sanches199538838817<style face="normal" font="default" charset="238" size="100%">Tracing the origin of an outbreak of methicillin-resistant </style><style face="italic" font="default" charset="238" size="100%">Staphylococcus aureus</style><style face="normal" font="default" charset="238" size="100%"> infections in a Portugese hospital by molecular fingerprinting methods</style>Microb Drug Resist<style face="normal" font="default" charset="238" size="100%">Nosocomial transmission of community-associated methicillin-resisitant Staphylococcus aureus: an emerging threat</style>http://infection.thelancet.com<style face="normal" font="default" charset="238" size="100%">Methicillin-resistant </style><style face="italic" font="default" charset="238" size="100%">Staphylococcus aureus i</style><style face="normal" font="default" charset="238" size="100%">n the Australian community: an evolving epidemic</style>Med J Aust(70).
Opisano je nekoliko PVL-pozitivnih MRSA SCCmec IV izolata Hrvatske ADDIN EN.CITE Krzyston-Russjan200623023017Krzyston-Russjan, J.Tambic-Andrasevic, A.Bukovski, S.Sabat, A.Hryniewicz, W.First community-acquired methicillin-resistant Staphylococcus aureus (MRSA) strains in CroatiaClin Microbiol InfectClin Microbiol Infect697-8127Community-Acquired Infections/drug therapy/microbiologyCroatiaHumans*Methicillin Resistance/geneticsStaphylococcal Infections/drug therapy/*microbiologyStaphylococcus aureus/*drug effects/genetics2006Jul16774575http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=16774575 (71), u opisu kojih su koritene g e n o t i p s k e z n a
a j k e , b e z e p i d e m i o l o ak i h k a r a k t e r i s t i k a .
D v a s u z e m l j o p i s n o o d i j e l j e n a k l o n a i z v a n b o l n i
k i h M R S A , j e d a n j e p a n d e m i j s k i , r a s p r o s t r a n j e n u s v i j e t u , ( S T 3 0 ) a o s t a l i s u s p e c i f i
n i z a o d r e e n e k o n t i n e n t e ( S T 1 , S T 8 i S T 8 0 ) . P a n d e m i j s k i t i p p o s j e d u j e g e n z a s i j a l o p r o t e i n s k i k o at a n i a d h e z i n , b b p , k o j i s e p o v e z u j e s o s t e o m i j e l i t i s o m , a i g e n z a k o l a g e n s k i a d h e z i n , c n a , k o j i , z a r a z l i k u o d b b p , m o ~e m o n a i i u n e p a n d e m i j s k i m t i p o v i m a A D D I N E N . C I T E < E n d N o t e > < C i t e > < A u t h o r > O t s u k a < / A u t h o r > < Y e a r > 2 0 0 6 < / Y ear>39639617<style face="normal" font="default" charset="238" size="100%">Key adhesin gene in community-acquired methicillin-resistant </style><style face="italic" font="default" charset="238" size="100%">Staphylococcus aureus</style>Biochem Biphys Res Commun(72).
Podrijetlo i z v a n b o l n i
k i h M R S A
N i j e p o t p u n o r a z j a an j e n o j e l i S C C m e c e l e m e n t i z v a n b o l n i
k i h M R S A d o s p i o h o r i z o n t a l n i m t r a n s f e r o m u M S S A i z o l a t e A D D I N E N . C I T E < E n d N o t e > < C i t e > < A u t h o r > M o n g k o l r a t t a n o t h a i < / A u t h o r > < Y e a r > 2 0 0 3 < / Y e a r > < R e c N u m > 2 9 4 < / R e c N u m > < r e c o r d > < r e c - n u m b e r >29417Mongkolrattanothai, K.Boyle, S.Kahana, M. D.Daum, R. S.Section of Pediatric Infectious Diseases, University of Chicago, Department of Pediatrics, Chicago, Illinois 60637, USA.Severe Staphylococcus aureus infections caused by clonally related community-acquired methicillin-susceptible and methicillin-resistant isolatesClin Infect DisClin Infect Dis1050-8378AdolescentAdultChildChild, PreschoolCommunity-Acquired Infections/*microbiologyFemaleHumansInfantMaleMethicillin/*pharmacologyMethicillin Resistance/*geneticsMicrobial Sensitivity TestsStaphylococcal Infections/*microbiologyStaphylococcus aureus/*drug effects/genetics2003Oct 1514523769http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=1452376 9 < / u r l > < / r e l a t e d - u r l s > < / u r l s > < / r e c o r d > < / C i t e > < / E n d N o t e > ( 2 1 ) i l i s u i z v a n b o l n i
k i M R S A n a s t a l i o d b o l n i
k i h s o j e v a , t e s u , n a k o n at o s u d o s p j e l i u i z v a n b o l n i
k u s r e d i n u , u s r e d i n u o s l o b o e n u a n t i b i o t s k o g p r i t i s k a , i z g u b i l i o s t a l e g e n e r e z i s t e n c i j e A D D IN EN.CITE Aires de Sousa200318918917Aires de Sousa, M.de Lencastre, H.Laboratorio de Genetica Molecular, Instituto de Tecnologia Quimica e Biologica da Universidade Nova de Lisboa, Oeiras, Portugal.Evolution of sporadic isolates of methicillin-resistant Staphylococcus aureus (MRSA) in hospitals and their similarities to isolates of community-acquired MRSAJ Clin MicrobiolJ Clin Microbiol3806-15418AlgorithmsAmino Acid SequenceAsiaCommunity-Acquired Infections/*microbiologyCross Infection/*microbiologyEuropeEvolution, MolecularHumans*Methicillin ResistancePeptide Fragments/chemistryPrevalenceResearch Support, Non-U.S. Gov'tResearch Support, U.S. Gov't, P.H.S.South AmericaStaphylococcal Infections/*diagnosis/epidemiologyStaphylococcus aureus/drug effects/*genetics2003Aug12904393http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=12904393 (73).
U novijoj literaturi o b j a v l j e n o j e d a b o l n i
k i i i z v a n b o l n i
k i M R S A i m a j u s l i
n o p o d r i j e t l o . D o k a z a n o j e d a s e i s t i k l o n , p e n i c i l i n - r e z i s t e n t n i f a g o t i p 8 0 / 8 1 , k o j i j e h a r a o s v i j e t o m 1 9 5 0 - t i h , n a s t a v i o ai r i t i u b o l n i c a m a i u i z v a n b o l n i
k o j s r e d i n i , a n a k o n u v o e n j a s e m i s i n t e t s k i h p e n i c i l i n a b i o j e e r a d i c i r a n . P o n o v o s e j a v l j a k a o S T 3 0 M S S A i P V L j e p o z i t i v a n . O v a j k l o n s e p o n o v n o p r o ai r i o u r a z d o b l j u d o 1 9 9 0 . g o d i n e , u s v o j i o S C C m e c k a s e t u i p r e d s t a v l j a d o m i n a n t a n i z v a n b o l n i
k i M R S A u A u s t r a l i j i . S T 3 0 j e t a k o e r u s v o j i o i S C C m e c t i p I I , i p o s t u p n o , u z o d r e e n e m u t a c i j e p o s t a o S T 3 6 - M R S A - I I , p a n d e m i j s k i E M R S A - 1 6 A D D I N E N . C I T E < E n d N o t e > < C i t e > < A u t h o r > R o b i n s o n < / A u t h o r > < Y e a r > 2 0 0 5 < / Y e a r > < R e c N u m > 1 9 0 < / R e c N u m > < r e c o r d > < r e c - n u m b e r > 1 9 0 < / r e c - n u m b e r > < r e f - t y p e n a m e = " J o u r n a l A r t i c l e " > 1 7 < / r e f -type>Robinson, D. A.Kearns, A. M.Holmes, A.Morrison, D.Grundmann, H.Edwards, G.O'Brien, F. G.Tenover, F. C.McDougal, L. K.Monk, A. B.Enright, M. C.Department of Biology and Biochemistry, University of Bath, Bath, UK.Re-emergence of early pandemic Staphylococcus aureus as a community-acquired meticillin-resistant cloneLancetLancet1256-83659466Australia/epidemiologyBacteriophage TypingCanada/epidemiologyCommunity-Acquired InfectionsDisease OutbreaksGenes, BacterialGenotypeHumansLeukocidins/genetics*Methicillin ResistanceResearch Support, Non-U.S. Gov'tStaphylococcal Infections/*epidemiology/microbiologyStaphylococcus Phages/classificationStaphylococcus aureus/*genetics2005Apr 2-815811459 < u r l > h t t p : / / w w w . n c b i . n l m . n i h . g o v / e n t r e z / q u e r y . f c g i ? c m d = R e t r i e v e & a m p ; d b = P u b M e d & a m p ; d o p t = C i t a t i o n & a m p ; l i s t _ u i d s = 1 5 8 1 1 4 5 9 < / u r l > < / r e l a t e d - u r l s > < / u r l s > < / r e c o r d > < / C i t e > < / E n d N o t e > ( 7 4 ) .
N a d a l j e , t r i S C C m e c e l e m e n t a k o j i s a d r ~e g e n e k o j i k o d i r a j u b i o s i n t e t i
k e e n z i m e z a k a p s u l a r n e p o l i s a h a r i d e o p i s a n i s u u M S S A , S . e p i d e r m i d i s i S . h o m i n i s . O v i e l e m e n t i i m a j u m n o g e z a j e d n i
k e k a r a k t e r i s t i k e s a S C C m e c , u k l j u
u j u i i r e g u l a t o r n e g e n e i i n s e r c i j s k e s e k v e n c e , a l i i m n e d o s t a j e m e c A g e n . Z a n i m l j i v o j e d a s u s e k v e n c e u L - C r e g i j i S C C m e c t i p a I V i d e n t i
n e r e g i j i p r o n a e n o j k o d S . e p i d e r m i d i s , at o s v e u k a z u j e n a e k s t e n z i v a n h o r i z o n t a l n i t r a n s f e r g e n a i z m e u s t a f i l o k o k n i h v r s t a A D D I N E N . C I T E < E n d N o t e > < C i t e > < A u t h o r > W i s p l i n g h o f f < / A u t h o r > < Y e a r > 2 0 0 3 < / Y e a r > < R e c N u m > 1 0 4 < / R e c N u m > < r ecord>10417Wisplinghoff, H.Rosato, A. E.Enright, M. C.Noto, M.Craig, W.Archer, G. L.Division of Infectious Diseases, Department of Internal Medicine, Virginia Commonwealth University, Richmond, Virginia 23292, USA.Related clones containing SCCmec type IV predominate among clinically significant Staphylococcus epidermidis isolatesAntimicrob Agents ChemotherAntimicrob Agents Chemother3574-94711AllelesBacterial Proteins/*geneticsDNA PrimersGenotypeMethicillin ResistanceResearch Support, U.S. Gov't, P.H.S.Reverse Transcriptase Polymerase Chain ReactionStaphylococcal Infections/*microbiologyStaphylococcus epidermidis/*genetics2003Nov14576120http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=14576120 ( 2 5 ) .
Z a n i m l j i v a j e
i n j e n i c a d a j e S S C m e c t i p I V e l e m a n t b i o d o m i n a n t a n u i z o l a t i m a S t a p h y l o c o c c u s e p i d e r m i d i s i 1 9 7 0 - t i h g o d i n a a d a j e r i j e t k a p o j a v a m e u S . a u r e u s p r i j e 1 9 9 0 . g o d i n e A D D I N E N . C I T E < E n d N o t e > < C i t e > < A u t h o r > L u o n g < / A u t h o r > < Y e a r > 2 00233633617<style face="normal" font="default" charset="238" size="100%">Type 1 capsule genes of Staphylococcus aureus are carried in a staphylococcal cassette chromosome genetic element.</style>J BacteriolWisplinghoff200310410417Wisplinghoff, H.Rosato, A. E.Enright, M. C.Noto, M.Craig, W.Archer, G. L.Division of Infectious Diseases, Department of Internal Medicine, Virginia Commonwealth University, Richmond, Virginia 23292, USA.Related clones containing SCCmec type IV predominate among clinically significant Staphylococcus epidermidis isolatesAntimicrob Agents ChemotherAntimicrob Agents Chemother3574-94711AllelesBacterial Proteins/*geneticsDNA PrimersGenotypeMethicillin ResistanceResearch Support, U.S. Gov't, P.H.S.Reverse Transcriptase Polymerase Chain ReactionStaphylococcal Infections/*microbiologyStaphylococcus epidermidis/*genetics2003Nov14576120http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=14576120 (25, 75).
J e d a n o d p r i s t u p a i s t r a ~i v a n j u p o d r i j e t l a M R S A j e p a r a l e l n a a n a l i z a g e n o m a S . a u r e u s i o s t a l i h s t a f i l o k o k n i h v r s t a d a b i s e u t v r d i l a s l i
n o s t g e n a r a z i s t e n c i j e i o t k r i o m e h a n i z a m i s m j e r g e n s k o g t r a n s f e r a A D D I N E N . C I T E < E n d N o t e > < C i t e > < A u t h o r > H a n s s e n < / A u t h or>2004727217Hanssen, A. M.Kjeldsen, G.Sollid, J. U.Department of Microbiology and Virology, Institute of Medical Biology, University of Tromso, Tromso, Norway. annemh@fagmed.uit.noLocal variants of Staphylococcal cassette chromosome mec in sporadic methicillin-resistant Staphylococcus aureus and methicillin-resistant coagulase-negative Staphylococci: evidence of horizontal gene transfer?Antimicrob Agents ChemotherAntimicrob Agents Chemother285-96481Blotting, SouthernCoagulase/metabolismDNA, Bacterial/chemistry/geneticsElectrophoresis, Polyacrylamide GelGene Transfer, Horizontal/*geneticsGenotypeHumansMethicillin Resistance/*geneticsMicrobial Sensitivity TestsPhenotypePhylogenyRNA, Bacterial/chemistry/geneticsResearch Support, Non-U.S. Gov'tReverse Transcriptase Polymerase Chain ReactionStaphylococcal Infections/microbiologyStaphylococcus aureus/*drug effects/enzymology/*genetics2004Jan14693553http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=14693553 (76) . N a e n a j e d o b r a k o n z e r v i r a n o s t n u k l e o t i d n i h s e k v e n c i c c r A B a l e l a n a i s t o m z e m l j o p i s n o m p o d r u
j u a m e u r a z l i
i t i m s t a f i l o k o k n i m v r s t a m a , S . w a r n e r i i S . e p i d e r m i d i s z a j e d n o s a S . a u r e u s . M a l o s e z n a o s t r u k t u r i S C C m e c k o m p l e k s a u k o a g u l a z a - n e g a t i v n i h s t a f i l okoka (KNS) ADDIN EN.CITE CoNS917Ma, X. X.Galiana, A.Pedreira, W.Mowszowicz, M.Christophersen, I.Machiavello, S.Lope, L.Benaderet, S.Buela, F.Vincentino, W.Albini, M.Bertaux, O.Constenla, I.Bagnulo, H.Llosa, L.Ito, T.Hiramatsu, K.Juntendo University, Tokyo, Japan.Community-acquired methicillin-resistant Staphylococcus aureus, UruguayEmerg Infect DisEmerg Infect Dis973-6116Adhesins, Bacterial/geneticsAdultAnti-Bacterial Agents/pharmacologyCommunity-Acquired Infections/*epidemiology/microbiology/mortality*Disease Outbreaks*Drug Resistance, Multiple, Bacterial/geneticsHumansLeukocidins/genetics*Methicillin ResistanceMicrobial Sensitivity TestsMiddle AgedResearch Support, Non-U.S. Gov'tStaphylococcal Infections/*epidemiology/microbiology/mortalityStaphylococcus aureus/*drug effects/genetics/pathogenicityUruguay/epidemiology2005Jun15963301http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=15963301 < / u r l > < / r e l a t e d - u r l s > < / u r l s > < / r e c o r d > < / C i t e > < / E n d N o t e > ( 1 7 ) , v e i n a s t u d i j a k o n c e n t r i r a n a j e n a M R S A , a l i p o s t o j e s n a ~n i a r g u m e n t i k o j i g o v o r e o K N S k a o i z v o r u g e n a r e z i s t e n c i j e z a S . a u r e u s a i d r u g e g r a m - p o z i t i v n e m i k r o o r g a n i z m e A D D I N E N . C I T E < E n d N o t e>John199338138117<style face="normal" font="default" charset="238" size="100%">Widespread colonisation of personnel at a Veterans Affairs medical center by methicillin-resistant, coagulase-negative Staphylococus</style>Clin Infect DisKlingenberg200138238217<style face="normal" font="default" charset="238" size="100%">Rapid PCR detection of the methicillin-resistance gene, mecA, on the hands of medical and non-medical personnel and healthy children and on surfaces in a neonatal intensive care unit</style>Scand J Infect DisMcDonnel198338338317<style face="normal" font="default" charset="238" size="100%">Conjugational transfer ofj gentamicin resistance plasmids intra-and interspecifically in </style><style face="italic" font="default" charset="238" size="100%">Staphylococcus aureus </style><style face="normal" font="default" charset="238" size="100%">and </style><style face="italic" font="default" charset="238" size="100%">Staphylococcus epidermdis </style>Antimicrob Agents ChemotherMonsen199938438417<style face="normal" font="default" charset="238" size="100%">Antibiotic susceptibility of staphylococci isolated in blood cultures in relation to antibiotic consumption in hospital wards</style>Scand J Infect Dis(77-80). N e m a j e d n o z n a
n i h p o k a z a t e l j a m e h a n i z m a i s m j e r a , n i m i k r o o r g a n i z m a k o j i b i b i o o d g o v o r a n z a m e c A t r a n s f e r , a l i n e k i a u t o r i s u g e r i r a j u d a s e t r a n s f e r m e c A o d v i o i z K N S u S . a u r e u s A D D I N E N . C I T E < E n d N o t e > < C i t e > < A u t h o r > A r c h e r < / A u t h o r > < Y e a r > 1 9 9 4 < / Y e a r > < R e c N um>38538517<style face="normal" font="default" charset="238" size="100%">Dissemination among staphylococci of DNA sequences associated with methicillin-resistance </style>Antimicrob Agents Chemother(81). Wielders i suradnici su izvijestili o m o g u e m h o r i z o n t a l n o m i n v i v o t r a n s f e r u m e c A u S . a u r e u s u z p r i s u t n o s t m e t i c i l i n - r e z i s t e n t n o g i z o l a t a K N S z a v r i j e m e a n t i b i o t s k e t e r a p i j e , g d j e j e d e n o v o n a s t a o M R S A s o j A D D I N E N . C I T E < E n d N o t e > < C i t e > < A u t h o r > W i e l d e r s < / A u t h o r > < Y e a r > 2 0 0 1 < / Y e a r > < R e c N u m > 2 9 5 < / RecNum>29517Wielders, C. L.Vriens, M. R.Brisse, S.de Graaf-Miltenburg, L. A.Troelstra, A.Fleer, A.Schmitz, F. J.Verhoef, J.Fluit, A. C.In-vivo transfer of mecA DNA to Staphylococcus aureus [corrected]LancetLancet1674-53579269Bacteremia/microbiology*Bacterial ProteinsCarrier Proteins/*geneticsCross Infection/microbiologyDNA FingerprintingDNA, Bacterial/*geneticsGene Transfer, Horizontal/*geneticsGenotype*HexosyltransferasesHumansInfant, NewbornMaleMicrobial Sensitivity TestsMuramoylpentapeptide Carboxypeptidase/*geneticsPenicillin-Binding Proteins*Peptidyl TransferasesStaphylococcal Infections/microbiologyStaphylococcus aureus/*genetics2001May 2611425376http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=11425376 (22). Postojanje homologa SCCmec g e n u k o d k o m e n z a l n e s t a f i l o k o k n e v r s t e p o t v r u j e t v r d n j u o r e z e r v o a r u r e z i s t e n t n i h g e n s k i h d i j e l o v a k o d d r u g i h s t a f i l o k o k n i h v r s t a A D D I N E N . C I T E < E n d N o t e > < C i t e > < A u t h o r > M o n g k o l r a t t a n o t h a i < / A u t h o r > < Y e a r > 2 0 0 4 < / Y e a r > < R e c N u m > 8 1 < / R e c N u m > < r e c o r d > < r e c - n u m b e r > 8 1 < / rec-number>17Mongkolrattanothai, K.Boyle, S.Murphy, T. V.Daum, R. S.Section of Pediatric Infectious Diseases, Department of Pediatrics, University of Chicago, Chicago, Illinois 60637, USA.Novel non-mecA-containing staphylococcal chromosomal cassette composite island containing pbp4 and tagF genes in a commensal staphylococcal species: a possible reservoir for antibiotic resistance islands in Staphylococcus aureusAntimicrob Agents ChemotherAntimicrob Agents Chemother1823-36485Amino Acid SequenceBacterial Proteins/*geneticsBase SequenceCarrier Proteins/*geneticsChildChromosomes, Bacterial/*geneticsDNA, Bacterial/geneticsDrug Resistance, Bacterial/*geneticsHexosyltransferases/*geneticsHumansMethicillin Resistance/geneticsMolecular Sequence DataMultigene Family/geneticsMuramoylpentapeptide Carboxypeptidase/*geneticsPenicillin-Binding ProteinsPeptidyl Transferases/*geneticsPolymorphism, Restriction Fragment LengthPregnancy Proteins/*geneticsRecombination, GeneticRepetitive Sequences, Nucleic AcidResearch Support, Non-U.S. Gov'tResearch Support, U.S. Gov't, P.H.S.Reverse Transcriptase Polymerase Chain ReactionStaphylococcal Infections/microbiologyStaphylococcus/drug effects/*geneticsStaphylococcus aureus/drug effects/geneticsStaphylococcus epidermidis/drug effects/geneticsTransferases (Other Substituted Phosphate Groups)/*genetics2004May15105141http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=15105141 ( 1 8 ) .
S m a t r a s e d a j e h o r i z o n t a l n i m t r a n s f e r o m S C C m e c t i p a I V , k o j e g j e
e s t o m o g u e n a i m e u z d r a v i m p o j e d i n c i m a , d o al o d o k o n v e r z i j e k o l o n i z i r a j u e g S . a u r e u s u M R S A A D D I N E N . C I T E < E n d N o t e > < C i t e > < A u t h o r > H i r a m a t s u < / A u t h o r > < Y e a r > 2 0 0 1 < / Y e a r > < R e c N um>252517Hiramatsu, K.Cui, L.Kuroda, M.Ito, T.Department of Bacteriology, Juntendo University, 2-1-1 Hongo Bunkyo-ku, Tokyo 113-8421, Japan. hiram@med.juntendo.ac.jpThe emergence and evolution of methicillin-resistant Staphylococcus aureusTrends MicrobiolTrends Microbiol486-93910*Bacterial ProteinsCarrier Proteins/geneticsDNA Transposable ElementsEpidemiology, Molecular*Evolution, Molecular*HexosyltransferasesHumansMethicillin Resistance/*geneticsMuramoylpentapeptide Carboxypeptidase/geneticsMutagenesis, InsertionalPenicillin-Binding Proteins*Peptidyl TransferasesResearch Support, Non-U.S. Gov'tStaphylococcal Infections/epidemiologyStaphylococcus aureus/*drug effects/geneticsVancomycin Resistance/geneticsbeta-Lactamases/genetics2001Oct11597450http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=11597450 (82).
V r i j e d n o j e s p o m e n u t i j o a j e d a n p o t e n c i j a l n i r e z e r v o a r z a i z v a n b o l n i
k e M R S A , r a d i s e o p r i j e n o s u M R S A i z ~i v o t i n j a A D D I N E N . C I T E < E n d N o t e > < C i t e > < A u t h o r > v a n D u i j k e r e n < / A u t h o r > < Y e a r > 2 0 0 4 < / Y e a r > < R e c N u m > 7 5 < / R e c N u m > < r e c o r d > < r e c - n u m b e r > 7 5 < / r e c - n u m b e r > < r e f - t y p e name="Journal Article">17van Duijkeren, E.Box, A. T.Heck, M. E.Wannet, W. J.Fluit, A. C.Bacteriology Division, Department of Infectious Diseases and Immunology, Faculty of Veterinary Medicine, Utrecht University, P.O. Box 80165, 3508 TD Utrecht, The Netherlands. E.duijkeren@vet.uu.nlMethicillin-resistant staphylococci isolated from animalsVet MicrobiolVet Microbiol91-71031-2Animal Diseases/*microbiologyAnimalsAnti-Bacterial Agents/*pharmacologyDNA, Bacterial/chemistry/geneticsElectrophoresis, Gel, Pulsed-Field/veterinary*Methicillin ResistanceMicrobial Sensitivity Tests/veterinaryNetherlandsOxacillin/*pharmacologyPolymerase Chain Reaction/veterinaryRNA, Ribosomal, 16S/chemistry/geneticsStaphylococcal Infections/microbiology/*veterinaryStaphylococcus/*drug effects/genetics/isolation & purification2004Oct 515381271 < r e l a t e d - u r l s > < u r l > h t t p : / / w w w . n c b i . n l m . n i h . g o v / e n t r e z / q u e r y . f c g i ? c m d = R e t r i e v e & a m p ; d b = P u b M e d & a m p ; d o p t = C i t a t i o n & a m p ; l i s t _ u i d s = 1 5 3 8 1 2 7 1 < / u r l > < / r e l a t e d - u r l s > < / u r l s > < / r e c o r d > < / C i t e > < / E n d N o t e > ( 8 3 ) , b i l o d a j e r i j e
o l j u b i m c u , p s u A D D I N E N . C I T E < E n d N o t e > < Cite>van Duijkeren2004777717van Duijkeren, E.Wolfhagen, M. J.Box, A. T.Heck, M. E.Wannet, W. J.Fluit, A. C.Faculty of Veterinary Medicine, Utrecht, The Netherlands. E.duijkeren@vet.uu.nlHuman-to-dog transmission of methicillin-resistant Staphylococcus aureusEmerg Infect DisEmerg Infect Dis2235-71012AdultAnimalsCarrier State/*transmission/veterinaryDog Diseases/microbiology/*transmissionDogsFemaleHumansInfantMaleMethicillin Resistance/*geneticsStaphylococcal Infections/*transmission/veterinaryStaphylococcus aureus/genetics/*isolation & purification*Zoonoses2004Dec15663871http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list _ u i d s = 1 5 6 6 3 8 7 1 < / u r l > < / r e l a t e d - u r l s > < / u r l s > < / r e c o r d > < / C i t e > < / E n d N o t e > ( 8 4 ) , k o n j u , m a
k i , i l i k o l o n i z a c i j a p r i j e l a z o m M R S A s ~i v o t i n j a u g o s p o d a r s t v u , s v i n j a , k r a v l j e g m l i j e k a A D D I N E N . C I T E < E n d N o t e > < C i t e > < A u t h o r > K w o n < / A u t h o r > < Y e a r > 2 0 0 5 < / Y e a r > < R e c N u m > 686817Kwon, N. H.Park, K. T.Moon, J. S.Jung, W. K.Kim, S. H.Kim, J. M.Hong, S. K.Koo, H. C.Joo, Y. S.Park, Y. H.Department of Microbiology, College of Veterinary Medicine and School of Agricultural Biotechnology, Seoul National University, Shillim dong, Gwanak gu, Seoul 151-742, Korea.Staphylococcal cassette chromosome mec (SCCmec) characterization and molecular analysis for methicillin-resistant Staphylococcus aureus and novel SCCmec subtype IVg isolated from bovine milk in KoreaJ Antimicrob ChemotherJ Antimicrob Chemother624-32564AnimalsBacterial Proteins/geneticsBase SequenceCattleHumansKoreaMethicillin/pharmacologyMethicillin Resistance/*geneticsMicrobial Sensitivity TestsMilk/*microbiologyMolecular Sequence DataPhylogenyResearch Support, Non-U.S. Gov'tStaphylococcal Infections/*microbiologyStaphylococcus aureus/classification/drug effects/*genetics/*isolation &purification2005Oct16126781http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=16126781 (85) a sumnja postoji n a p r i j e n o s s k o n t a m i n i r a n o g p i l e e g m e s a A D D I N E N . C I T E < E n d N o t e > < C i t e > < A u t h o r > K w o n < / A u t h o r > < Y e a r > 2 0 0 6 < / Y e a r > < R e c N u m > 3 9 7 < / R e c N u m > < r e c o r d > < r e c - n u m b e r > 3 9 7 < / r e c - n u m b e r > < r e f - t y p e n a m e = " J o u r n a l A r t i c l e " > 1 7 < / r e f - t y p e > < c o n t r i b u t o r s > < a u t h o r s > < a u t h o r > < s t y l e f a ce="normal" font="default" charset="238" size="100%">Kwon, N. H.<style face="normal" font="default" charset="238" size="100%">Characteristics of methicillin-resistant </style><style face="italic" font="default" charset="238" size="100%">Staphylococcus aureus</style><style face="normal" font="default" charset="238" size="100%"> isolated from chicken meat and hospitalized dogs in Korea and their epidemiological relatedness</style>Vet Microbiol < / d a t e s > < u r l s > < / u r l s > < / r e c o r d > < / C i t e > < / E n d N o t e > ( 8 6 ) .
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n e g r i p i , o o b o l j e l i m a o d p n e u m o n i j e k o j i i m a j u s i m p t o m e h e m o p t i z e , v i s o k o s u f e b r i l n i , l e u k o p e n i
n i i h i p o t e n z i v n i . T a k v i s i m p t o m i s i g n a l i z i r a j u ~i v o t n o u g r o ~a v a j u u i n f e k c i j u , n e k r o t i z i r a j u u p n e u m o n i j u , i l i s e p t i
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k i M R S A j e s u k o ~n e i n f e k c i j e , k o d k o j i h s e r a z v i j a j u a p s c e s , f u r u n k u l , k a r b u n k u l , b e z d r e n a ~e i n f e k c i j e p r o g r e d i r a j u u f a s c i i t i s , z a t i m d u b o k e i n f e k c i j e m e k i h t k i v a , n a k o n k o j i h , u k o l i k o d o e d o i z l j e
e n j a , o s t a j u d e f o r m a c i j e t k i v a .
D o b a r o d a b i r u z o r k a z a m i k r o b i o l o ak o t e s t i r a n j e , ( b r i s a , a s p i r a t a r a n e , i s k a al j a j a i l i a s p i r a t a t r a h e j e u s l u
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a j u p n e u m o n i j e ) , b r z a d e t e k c i j a M R S A u m i k r o b i o l o ak o m l a b o r a t o r i j u , k a o i r e z u l t a t i o s j e t l j i v o s t i n a o d g o v a r a j u e n e - b e t a l a t a m s k e a n t i b i o t i k e d o p r i n i j e t i e o d g o v a r a j u e m l i j e
a n j u i n f e k c i j a i p r a v o d o b n o m p o d u z i m a n j u m j e r a k o n t r o l e i n f e k c i j a s c i l j e m at o m a n j e g ai r e n j a v r l o p r i l a g o d l j i v i h i z v a n b o l n i
k i h M R S A s o j e v a u a m b u l a n t a m a i b o l n i
k o j s r e d i n i . P r i l i k o m o b r a d e b o l e s n i k a s i n f e k c i j o m u z r o k o v a n o m i z v a n b o l n i
k i m M R S A , p o t r e b n o j e p o d u z e t i m j e r e s p r e
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k e p r e d m e t e s d r u g i m b o l e s n i c i m a , k a o i k o d b o l n i
k i h M R S A . S m a t r a s e d a j e r e l a t i v n o v e l i k i b r o j e p i d e m i j s k i h i n f e k c i j a i z v a n b o l n i
k i m M R S A i z a z v a n u p r a v o p r e n o ae n j e m p a t o g e n a p r e k o p r e d m e t a z a j e d n i
k e u p o r a b e ( s a p u n i , r u
n i c i , b r i t v i c e ) .
Z a b i l j e ~e n j e i p r i j e n o s i z v a n b o l n i
k i h M R S A n a l a b o r a t o r i j s k e r a d n i k e A D D I N E N . C I T E < E n d N o t e > < C i t e > < A u t h o r >Wagenvoort200622822817Wagenvoort, J. H.De Brauwer, E. I.Gronenschild, J. M.Toenbreker, H. M.Bonnemayers, G. P.Bilkert-Mooiman, M. A.Department of Medical Microbiology, Atrium Medical Centre, Postbox 4446, 6401 CX, Heerlen, The Netherlands. medische.microbiologie@atriummc.nlLaboratory-acquired meticillin-resistant Staphylococcus aureus (MRSA) in two microbiology laboratory techniciansEur J Clin Microbiol Infect DisEur J Clin Microbiol Infect Dis470-22572006Jul16783560 < u r l s > < r e l a t e d - u r l s > < u r l > h t t p : / / w w w . n c b i . n l m . n i h . g o v / e n t r e z / q u e r y . f c g i ? c m d = R e t r i e v e & a m p ; d b = P u b M e d & a m p ; d o p t = C i t a t i o n & a m p ; l i s t _ u i d s = 1 6 7 8 3 5 6 0 < / u r l > < / r e l a t e d - u r l s > < / u r l s > < / r e c o r d > < / C i t e > < / E n d N o t e > ( 8 7 ) , a i n a l i j e
n i k a k o j i j e r e s u s c i t i r a o d i j e t e o b o l j e l o o d n e k r o t i z i r a j u e p n e u m o n i j e i z a z v a n e i z v a n b o l n i
k i m M R S A s o j e m A D D I N E N . C I T E < E n d N o t e > < C i t e > < A u t h o r > C h a l u m n e a u < / A u t h o r > < Y e a r > 2 0 0 5 < / Y e a r > < R e c N u m > 4 1 2 < / R e c N u m > < r e c o r d > < r e c - n u m b e r > 4 1 2 < / r e c - n u m b e r > < r e f - t y p e n a m e = " J o u r n a l A r t i c l e " > 1 7 < / r e f - t y p e > < c o n t r i b u t ors><style face="normal" font="default" charset="238" size="100%">Transmission of Panton-Valentine Leukocidin-Producing </style><style face="italic" font="default" charset="238" size="100%">Staphylococcus aureus </style><style face="normal" font="default" charset="238" size="100%">to a Physician during Resuscitation of a Child</style>Clin Infect Dis<style face="normal" font="default" charset="238" size="100%">Guidelines for the laboratory diagnosis and susceptibility testing of methicillin-resistant Staphylococcus aureus (MRSA)</style>J Antimicrob Chemother(89).
Test vezane koagulaze, na predmetnom stakalcu, je brz ali 15% S.aureus izolata je negativno te takvi izolati trebaju potvrdu slobodne koagulaze.
Lateks-aglutinacijski testovi za identifikaciju S.aureus n a j
e ae s u t e m e l j e n i n a d o k a z u p r o t e i n a A i l i v e z a n e k o a g u l a z e , p o z i t i v a n r e z u l t a t t e s t a t a k o e r p o k a z u j u i i z o l a t i S . l u g d u n e n s i s i S . s c h l e i f f e r i .
I s p i t i v a n j e d e o k s i r i b o n u k l e a z e ( D N A - z a ) m o ~e s e k o r i s t i t i k a o m e t o d a p r o b i r a a l i z b o g o d r e e n o g p o s t o t k a D NA-za pozitivnih KNS, pozitivni izolati trebaju potvrdu dodatnog testa ADDIN EN.CITE Brown200543243217<style face="normal" font="default" charset="238" size="100%">Guidelines for the laboratory diagnosis and susceptibility testing of methicillin-resistant Staphylococcus aureus (MRSA)</style>J Antimicrob Chemother(89).
Postoji niz komercijalnih biokemijskih testova i automatiziranih sustava za identifikaciju S.aureus, nedostatak im je visoka cijena i relativna sporost u odnosu na npr. testiranje vezane i slobodne koagulaze.
M o l e k u l a r n i t e s t o v i s u p r e c i z n i , n e m a p o t r e b e z a k o n f i r m a t i v n i m m e t o d a m a , v e i n a i h u o s n o v i s a d r ~i a m p l i f i k a c i j s k e t e h n i k e . C i l j n i g e n i s u i m : g e n z a n u k l e a z u ( n u c ) , k o a g u l a z u ( c o a ) , p r o t e i n A ( s p a ) , f e m A i f e m B , S a 4 4 2 , 1 6 S r R N A i g e n i k o j i k o d i r a j u p r o t e i n e k o j i s e v e ~u n a f i b r i n o g e n A D D I N E N . C I T E < E n d N o t e > < C i t e > < A u t h o r > M a s o n < / A u t h o r > < Y e a r > 2 0 0 1 < / Y e a r > < R e c N u m > 4 3 7 < / R e c N u m > < r e c o r d > < r e c - n u m b e r > 4 3 7 < / r e c - n u m b e r > < r e f - t y p e n a m e = " J o u r n a l A r t i c l e " > 1 7 < / r e f - t y p e > < c o n t r i b u t o r s > < a u t h o r s > < a u t h o r > < s t y l e f a c e = " n o r m a l " f ont="default" charset="238" size="100%">Mason, W.J.<style face="normal" font="default" charset="238" size="100%">Multiplex PCR protocol for the diagnosis of staphylococcal infection </style>J Clin Microbiol(90). Zbog visoke cijene molekularnih metoda, njihova p r i m j e n a s e p r e p o r u
u j e s a m o u o d r e e n i m s l u
a j e v i m a , u k o j i m a k o v e n c i o n a l n e m e t o d e d a j u d v o j b e n e r e z u l t a t e t e k o d i z r a ~e n e s u m n j e n a M R S A i n f e k c i j u A D D I N E N . C I T E < E n d N o t e > < C i t e > < A u t h o r > B r o w n < / A u t h o r > < Y e a r > 2 0 0 5 < / Y e a r > < R e c N u m > 4 3 2 < / R e c N u m > < r e c o r d > < r e c - n umber>43217<style face="normal" font="default" charset="238" size="100%">Guidelines for the laboratory diagnosis and susceptibility testing of methicillin-resistant Staphylococcus aureus (MRSA)</style>J Antimicrob Chemother < / C i t e > < / E n d N o t e > ( 8 9 ) .
I s p i t i v a n j e o s j e t l j i v o s t i n a m e t i c i l i n ( o k s a c i l i n )
N a k o n i d e n t i f i k a c i j e s l i j e d i t e s t i r a n j e o s j e t l j i v o s t i i z o l a t a n a o k s a c i l i n / c e f o k s i t i n .
R e f e r e n t n a m e t o d a , z l a t n i s t a n d a r d u o d r e i v a n j u m e t i c i l i n s k e r e z i s t e n c i j e j e p r i s u t n o s t m e c A g e n a . U n a t o
t o m e , u v e i n i r u t i n s k i h m i k r o b i o l o ak i h l a b o r a t o r i j a s e n a j
e ae k o r i s t e f e n o t i p s k e m e t o d e , d i s k - d i f u z i j a , i o k s a c i l i n s k a p r o b i r n a p l o
a , a p o s t o j e i k o m e r c i j a l n i i a u t o m a t i z i r a n i s i s t e m i z a d e t e k c i j u m e t i c i l i n s k e r e z i s t e n c i j e A D D I N E N .CITE Brown200543243217<style face="normal" font="default" charset="238" size="100%">Guidelines for the laboratory diagnosis and susceptibility testing of methicillin-resistant Staphylococcus aureus (MRSA)</style>J Antimicrob Chemother<style face="normal" font="default" charset="238" size="100%">Performace Standards for Antimicrobial Susceptibility Testing; Sixteenth Informational Supplement. CLSI document M-100</style>(91). Jo uvijek se, m e u t i m , u o d r e i v a n j u M I K u p o t r e b l j a v a o k s a c i l i n j e r n e m a s t a n d a r d i z i r a n i h p r i j e l o m n i h t o
k i z a c e f o k s i t i n A D D I N E N . C I T E < E n d N o t e > < C i t e > < A u t h o r > C l i n i c a l a n d l a b o r a t o r y s t a n d a r d s i n s t i t u t e < / A u t h o r > < Y e a r > 2 0 0 6 < / Y e a r > < R e c N u m > 3 1 8 < / R e c N u m > < r e c o r d > < r e c - n u m b e r > 3186<style face="normal" font="default" charset="238" size="100%">Performace Standards for Antimicrobial Susceptibility Testing; Sixteenth Informational Supplement. CLSI document M-100</style>(91). U izboru m e d i j a i p o d l o g a z a t e s t i r a n j e o s j e t l j i v o s t i n a j k o n z i s t e n t n i j i r e z u l t a t i d o b i v a j u s e u z k o r i at e n j e M u e l l e r - H i n t o n ( M H ) m e d i j a . V r i j e m e i n k u b a c i j e u m e t o d i d i s k d i f u z i j e a i d i l u c i j s k i m m e t o d a m a ( a g a r d i l u c i j i i d i l u c i j i u b u j o n u ) , p r e p o r u
e n o z a d e t e k c i j u o k s a c i l i n s k e r e z i s t e n c i j e j e 2 4 s a t a , v r i j e m e z a d e t e k c i j u r e z i s t e n c i j e p r i m j e n o m c e f o k s i t i n a j e t a k o e r 2 4 s a t a i a k o o d r e e n i a u t o r i s u g e r i r a j u d a n e m a r a z l i k e u o s j e t l j i v o s t i i s p e c i f i
n o s t i a k o s e i n k u b a c i j a s k r a t i n a 1 8 s a t i A D D I N E N . C I T E < E n d N o t e > Skov200643643617<style face="normal" font="default" charset="238" size="100%">Phenotypic Detection of Methicillin Resistance in </style><style face="italic" font="default" charset="238" size="100%">Staphylococcus aureus</style><style face="normal" font="default" charset="238" size="100%"> by Disk-Diffusion Testing and Etest on Mueller-Hinton Agar</style>J Clin Microbiol(92).
Primjenom E testa (AB Biodisk, Solna, vedska) oksacilina i cefoksitina dobivaju se vrijednosti MIK-a usporedive s ostalim MIK i difuzijskim metodama, uz upotrebu MH agara s 2% NaCl , standardnim inokulumom kao i za disk-difuziju (0,5 McFalrland- do 1 McFarland) i vremenom inkubacije od 24 ili, za cefoksitin 18 sati ADDIN EN.CITE Skov200643643617<style face="normal" font="default" charset="238" size="100%">Phenotypic Detection of Methicillin Resistance in </style><style face="italic" font="default" charset="238" size="100%">Staphylococcus aureus</style><style face="normal" font="default" charset="238" size="100%"> by Disk-Diffusion Testing and Etest on Mueller-Hinton Agar</style>J Clin Microbiol(92). Prednost E testa je jednostavnost primjene a nedostatak relativno visoka cijena.
U p o t r e b a p r o b i r n e p l o
e s 6 m g / L o k s a c i l i n a i 4 % N a C l t a k o e r j e m e t o d a k o j o m s e m o ~e u t v r d i t i m e t i c i l i n s k a r e z i s t e n c i j a .
I z o l a t i k o j i s u m e c A p o z i t i v n i s i z r a z i t o h e t e r o g e n o m p o p u l a c i j o m m o g u b i t i z a m i j e n j e n i s i z o l a t i m a g r a n i
n o r e z i s t e n t n i m a n a o k s a c i l i n ( B O R S A ) . T i p i
n o z a i z o l a t e k o j i p r o d u c i r a j u v e l i k e k o l i
i n e b e t a - l a k t a m a z e j e d a u d i s k d i f u z i j i i m a j u s m a n j e n u z o n u i n h i b i c i j e , z a r a z l i k u o d p r a v i h M R S A k o j i u o p e n e p o k a z u j u z o n u i n h i b i c i j e o k o t e s t i r a n o g d i s k a A D D I N E N . C I T E < E n d N o t e > < C i t e > < A u t h or>Brown200543243217<style face="normal" font="default" charset="238" size="100%">Guidelines for the laboratory diagnosis and susceptibility testing of methicillin-resistant Staphylococcus aureus (MRSA)</style>J Antimicrob Chemother<style face="normal" font="default" charset="238" size="100%">Guidelines for the laboratory diagnosis and susceptibility testing of methicillin-resistant Staphylococcus aureus (MRSA)</style>J Antimicrob Chemother < u r l s > < / u r l s > < / r e c o r d > < / C i t e > < / E n d N o t e > ( 8 9 ) .
D e t e k c i j a M R S A u p r o b i r n i m ( s c r e e n i n g ) u z o r c i m a
P r o b i r M R S A i z o l a t a n a k r u t i m p o d l o g a m a s i l i b e z p r e t h o d n o g i n k u b i r a n j a u t e k u e m o b o g a u j u e m m e d i j u j e n a j
e ae o p i s a n . U t u s v h u k o r i s t e s e a g a r s m anitolom i NaCl (engl. mannitol salt agar, MSA), oksacilinski porbirni agar (egl oxacillin resistance screening agar, ORSAB), Baird-Parker podloga s ciprofloksacinom (BPC), kao i vie vrsta kromogenih agara (MRSA Select, Bio-Rad; CHROMagar MRSA-BioConnections; MRSA ID, BioMerieux).
Z a p o v e a n j e o s j e t l j i v o s t i p r o b i r a ,
e s t o s e z a d e t e k c i j u M R S A u z o r a k a k o j i n i s u p r i m a r n o s t e r i l n i p r o v e d e p r e k o n o n a i n k u b a c i j a u t e k u e m h r a n j i v o m m e d i j u s a n t i b i o t i c i m a i n a k o n t o g a z a s i j a v a n a k r u t u p o d l o g u . U i s t o j e p r u v e t i i n k u b i r a s e v i ae p r o b i r n i h u z o r a k a i s t o d o b n o , at o p o v e a v a v j e r o j a t n o s t o t k r i v a n j a k l i c o n o at v a a s m a n j u j e i c i j e n u p r e t r a g e . N a j
e ae k o r i at e n e t e k u e p o d l o g e s u M H b u j o n , m o ~d a n o - s r
a n i b u j o n ( e n g l . b r a i n - h e a r t i n f u s i o n b r o t h , B H I ) , t r i p t o n s k i s o j a b u j o n , R o b e r t s o n o v h r a n j i v i b u j o n , a s e l e k t i v n e t v a r i s u o b i
n o N a C l i o k s a c i l i n i l i c e f o k s i t i n a t a k o e r s u o p i s a n e t e k u e p o d l o g e k o j i m a s u i n k o r p o r i r a n i i n d i k a t o r i r a s t a A D D I N E N . C I T E < E n d N o t e > < C i t e > < A u t h o r > B r o w n < / A u t h o r > < Y e a r > 2 0 0 5 < / Y e a r > < R e c N u m > 4 3 2 < / R e c N u m > < r e c o r d > < r e c - n u m b e r > 4 3 2 < / rec-number>17<style face="normal" font="default" charset="238" size="100%">Guidelines for the laboratory diagnosis and susceptibility testing of methicillin-resistant Staphylococcus aureus (MRSA)</style>J Antimicrob Chemother ( 8 9 ) .
N e p o s t o j i t a k a v m e d i j u k o m e b i b i l o m o g u e o t k r i t i s v a k i M R S A s o j , k o m b i n a c i j o m r a s p o l o ~i v i h m e t o d a p o ~e l j n o b i b i l o u s v a k o m l a b o r a t o r i j u p o d i i o s j e t l j i v o s t i b r z i n u d e t e k c i j e M R S A p r o b i r n i h i z o l a t a . N o v i j e m e t o d e m o l e k u l a r n e d i j a g n o s t i k e k o j e i s t o d o b n o o t k r i v a j u m e c A g e n i d i o g e n o m a k o j i j e s p e c i f i
a n z a S . a u r e u s p r e d s t a v l j a j u z n a
a j a n p o m a k u d e t e k c i j i M R S A i z p r o b i r n i h i z o l a t a .
N o v i j e P C R m e t o d e n e k o r i s t e a m p l i f i k a c i j u m e c A k a o d o k a z M R S A , j e r p o s t o j i m o g u n o s t d o b i v a n j a l a ~n o - p o z i t i v n i h r e z u l t a t a a m p l i f i k a c i j o m m e c A g e n a k o a g u l a z a - n e g a t i v n i h s t a f i l o k o k a k o j i m o g u k o n t a m i n i r a t i u z o r a k . I D I - M R S A ( I n f e c t o D i a g n o s t i c , K a n a d a - B D ) i G e n o T y p e M R S A D i r e c t ( H a i n L i f e s c i e n c e , N j e m a
k a ) , d e t e k t i r a j u d i o o r f X g e n a , k o j i j e s p e c i f i
a n z a S . a u r e u s i s u s j e d n i d i o S C C m e c k r o m o s o m s k e r e g i j e . N a t a j n a
i n s e j e d n o m P C R r e a k c i j o m d e t e k t i r a M R S A i z n e s t e r i l n i h u z o r a k a . R e z u l t a t i s e d o b i j u z a 2 - 4 s a t a .
M a l i b r o j r u t i n s k i h l a b o r a t o r i j a u H r v a t s k o j i m a n a r a s p o l a g a n j u m o l e k u l a r n e m e t o d e , p a s u o n e o g r a n i
e n e n a v e l i k e i r e f e r e n t n e c e n t r e .
B r z a d e t e k c i j a v i r u l e n t n i h i z v a n b o l n i
k i h M R S A s o j e v a v a ~n a j e i z b o g p r i m j e n e m j e r a s p r e
a v a n j a p r e n o ae n j a i n f e k c i j a p r i l i k o m p r i j e m a u b o l n i c u A D D I N E N . C I T E < E n d N o t e > < C i t e > < A u t h o r > B e c k e r < / A u t h o r > < Y e a r > 2 0 0 3 < / Y e a r >32032017<style face="normal" font="default" charset="238" size="100%">Prevalence of genes encoding pyrogenic toxin superantigens and exfoliative toxins among strains of </style><style face="italic" font="default" charset="238" size="100%">Staphylococcus aureus</style><style face="normal" font="default" charset="238" size="100%"> isolated from blood and nasal specimens. </style>J Clin Microbiol(94) bolesnika s i z v a n b o l n i
k o m M R S A i n f e k c i j o m i b o r a v k a n a o d j e l i m a s t e ak i m b o l e s n i c i m a z a k o j e i n f e k c i j a m o ~e i m a t i f a t a l a n u
i n a k . N e k i a u t o r i s u g e r i r a j u p r o b i r b o l e s n i k a u j e d i n i c a m a i n t e n z i v n e n j e g e s c i l j e m p o b o l j aa n j a i s h o d a l i j e
e n j a A D D I N E N . C I T E < E n d N o t e > < C i t e>Wilson200622622617Wilson, A. P.Hayman, S.Cepeda, J. A.Singer, M.Bellingan, G.Department of Clinical Microbiology, University College London Hospitals, London, UK.Screening for MRSA and GISA in the intensive care unitJ Hosp InfectJ Hosp Infect85-66412006Sep16820246http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=16820246 (95).
L i j e
e n j e i n f e k c i j a i z a z v a n i h i z v a n b o l n i
k i m M R S A s o j e v i m a
P r i i z b o r u a n t i b i o t i k a z a e m p i r i j s k o l i j e
e n j e i n f e k c i j a k o j e u i z v a n b o l n i
k i h b o l e s n i k a u z r o k u j u s t a f i l o k o k i p o t r e b n o j e u z e t i u o b z i r t e ~i n u i n f e k c i j e , p r i s u t n o s t r i z i
n i h f a k t o r a z a b o l n i
k i M R S A i l o k a l n u p r e v a l e n c i j u i z v a n b o l n i
k i h M R S A . V a n k o m i c i n s e s m a t r a l i j e k o m i z b o r a k o d t e ak i h , p o ~i v o t o p a s n i h i n f e k c i j a u p o d r u
j i m a s v e l i k o m p r e v a l e n c i j o m i z v a n b o l n i
k i h M R S A , d o k s e l i n e z o l i d s m a t r a l i j e k o m d r u g o g i z b o r a u t a k v i m s l u
a j e v i m a A D D I N EN.CITE Bradley200535135117<style face="italic" font="default" charset="238" size="100%">Staphylococcus aureus</style><style face="normal" font="default" charset="238" size="100%"> pneumonia: emergence of MRSA in the community</style>Semin Respir Crit Care Med(96).
Nedavno su se pojavile pretpostavke ADDIN EN.CITE Micek2005
43143117<style face="normal" font="default" charset="238" size="100%">Pleuropulmonary Complications of Panton-Valentine Leucocidin-Positive Community-Acquired Methicillin-Resistant Staphylococcus aureus: importance of Treatment With Antimicrobials Inhibiting Exotoxin Production</style>Chest(97) d a b i u s l u
a j u i n f e k c i j a i z a z v a n i h i z v a n b o l n i
k i m M R S A k o j i p r o i z v o d e P V L t o k s i n n a j e f i k a s n i j i b i l i a n t i b i o t i c i k o j i d j e l u j u n a r i b o s o m a l n u t r a n s l a c i j u p r o t e i n a k a o at o s u l i n e z o l i d i k l i n d a m i c i n , z b o g r e d u k c i j e p r o d u k c i j e t o k s i n a ; n o , p r i j e n e g o at o s e p r i m i j e n i o v a j n a
i n l i j e
e n j a , p o t r e b n a j e i n v i v o p o t v r d a .
U e m p i r i j s k o j t e r a p i j i l a k ai h i n f e k c i j a , p r i s u m n j i n a s t a f i l o k o k n o g u z r o
n i k a , r a z u m n o j e i d a l j e p r i m j e n j i v a t i i k l o k s a c i l i n , i l i a l t e r n a t i v n i a n t i b i o t i k u s l u
a j u a l e r g i j e i l i i n t o l e r a n c i j e , a k o j e v e l i k i b r o j s t a f i l o k o k a i p a k o s j e t l j i v n a b e t a - l a k t a m s k e a n t i b i o t i k e .
N a k o n at o s e i d e n t i f i c i r a M R S A k a o u z r o
n i k i n f e k c i j e , t e r a p i j a s e m i j e n j a p r e m a a n t i b i o g r a m u . U t o m s l u
a j u p r e p o r u
u j u s e b r o j n i a n t i b i o t i c i ( n p r . k l i n d a m i c i n o s i m u s l u
a j e v i m a i n d u c i b i l n e r e z i s t e n c i j e ) . U p o t r e b a t e t r a c i k l i n a k a o at o j e d o k s i c i k l i n m o g u a j e u o v i m s l u
a j e v i m a , k a o i p r i m j e n a s u l f a m e t o k s a z o l - t r i m e t o p r i m a , k o j i s e p o k a z a o j e d n a k o v r i j e d n i m k a o i v a n k o m i c i n u l i j e
a n j u t e ak i h M R S A i n f e k c i j a i n t r a v e n s k i h o v i s n i k a o d r o g a m a , a u s p j e an i m s e p o k a z a o i u l i j e
e n j u l a k ai h i z v a n b o l n i
k i h M R S A i n f e k c i j a A D D I N E N . C I T E < E n d N o t e > < C i t e > < A u t h o r > M a r k o w i t z < / A u t h o r > < Y e a r > 1 9 9 2 < / Y e a r > < R e c N u m > 3 5 0 < / R e c N u m > < r e c o r d > < r e c - n u m b e r > 3 5 0 < / r e c - n u m b e r > < r e f - t y p e n a m e = " J o u r n a l A r t i c l e " > 1 7 < / r e f -type><style face="normal" font="default" charset="238" size="100%">Trimethoprim-Sulfamethoxazole Compared with Vancomycin for the Treatment of </style><style face="italic" font="default" charset="238" size="100%">Staphylococcus aureus</style><style face="normal" font="default" charset="238" size="100%"> Infection</style>Ann Intern Med(98).
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92. Skov R, Smyth R, Larsen A R i s u r . , P h e n o t y p i c D e t e c t i o n o f M e t h i c i l l i n R e s i s t a n c e i n S t a p h y l o c o c c u s a u r e u s b y D i s k - D i f f u s i o n T e s t i n g a n d E t e s t o n M u e l l e r - H i n t o n A g a r . J C l i n M i c r o b i o l 2 0 0 6 ; 4 4 : 4 3 9 5 - 4 3 9 9 .
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$d a$gdTMe $0d ^`0a$gdTMe munity-Acquired Methicillin-Resistant Staphylococcus aureus: importance of Treatment With Antimicrobials Inhibiting Exotoxin Production. Chest 2005
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98. Markowitz N, Quinn E L, Saravolatz L D, Trimethoprim-Sulfamethoxazole Compared with Vancomycin for the Treatment of Staphylococcus aureus Infection. Ann Intern Med 1992;117:390-398.
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